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An Approach to Oculomotor Anomalies in a Child
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
In patients with oculomotor anomalies, an assessment of binocularity is crucial to understanding the underlying disease. Furthermore, binocularity should be assessed at the beginning of the eye examination before fusion is broken down by dissociating tests. Oculomotor anomalies that disrupt fusion early in life typically are associated with permanent deficits in binocular vision; however, later-onset or intermittent oculomotor anomalies can be associated with moderate to excellent stereoacuity. Testing with the Worth-4-Dot test or Bagolini lenses can provide crude information related to gross levels of fusion. Stereoacuity testing with either a Contour Test or a Random Dot test can provide information related to higher levels of fusion.
The useful of botulinum toxin Type-A in the treatment of chronic sixth ocular nerve palsy
Published in Jan-Tjeerd de Faber, 28th European Strabismological Association Meeting, 2020
L. Sabetti, L. D’Alessandri, K. Salvatori, E. Balestrazzi
The orthoptic examination evaluated the ocular motility in the nine diagnostic gaze positions, strabismus was measured with the prism and cover test for near and distance fixation. The presence of anomalous head positions; Worth and micro-Worth, 4-dot test, Lang test (I–II), Titmus, TNO, red filter ladder test, Hess-Lancaster screen test and the passive and active duction test were performed. Inclusion criteria were VI nerve palsy more than 6 months after onset, anomalous head position. Exclusion criteria were previous surgical treatments, congenital abnormalities of extraocular muscles and the assumption of drugs interfering with the neuromuscular system in the last 6 months.
Strabismus
Published in Mostafa Khalil, Omar Kouli, The Duke Elder Exam of Ophthalmology, 2019
Ahmed Hassane, Rizwan Malik, Obaid Kousha
Simultaneous perception and fusion Worth 4-dot test, Bagolini glasses and synoptophore.
Contrast‐balanced binocular treatment in children with deprivation amblyopia
Published in Clinical and Experimental Optometry, 2018
Lisa M Hamm, Zidong Chen, Jinrong Li, Shuan Dai, Joanna Black, Junpeng Yuan, Minbin Yu, Benjamin Thompson
Across all participants, weaker eye global motion and dichoptic contrast interference thresholds improved with a similar magnitude over the two rounds of treatment. However, binocular motion coherence thresholds, which were normal for all groups after the first round of treatment, only showed modest improvements after additional treatment. Almost all participants exhibited further improvements in contrast interference threshold with additional treatment. EBD4 and EBD5 also showed an improvement on the Worth 4 Dot test (change from dominance to balance), whereas EUD3 showed a decrement change from diplopic under dichoptic conditions after her first round of treatment, to full suppression after her second round. No other changes were observed in the results of the Worth 4 Dot test, and no further changes in eye alignment of more than 5Δ.
The Functional Benefits of Strabismus Surgery
Published in Journal of Binocular Vision and Ocular Motility, 2018
In Scott’s series of 462 patients undergoing strabismus surgery for strabismus that began before visual maturity, 111 had infantile esotropia.1 Twenty-nine per cent of the congenital esotropes showed improvement in their response to the Worth 4-dot test in that they no longer showed suppression, and 23% developed some stereopsis (range 50–3,000 seconds of arc) after surgery. Of the 462 patients, 127 had acquired esotropia. Of them, 63% had an improvement in their Worth 4-dot test response and 46% showed improved stereopsis (range 40–3,000 seconds of arc) after surgery. One hundred sixty-one patients had surgery for exotropia. Seventy per cent of them improved on the Worth 4-dot test, and 70% showed improved stereopsis after surgery (range 40–3,000 seconds of arc).
Binocular vision disorders in a geriatric population
Published in Clinical and Experimental Optometry, 2022
Hassan Hashemi, Payam Nabovati, Abbas Ali Yekta, Mohammadreza Agha Mirsalim, Shokoofeh Rafati, Hadi Ostadimoghaddam, Mehdi Khabazkhoob
To evaluate suppression, the Worth 4-dot test was done using 1 red, 2 green, and 1 white flashlight dots at 40 cm and 6 m with the Worth 4 dot test box under light and dark conditions. To perform the test, red-green glasses were placed on the eyes of the participant (with red over the right eye) and the participant was asked about the number and colour of visible dots. If the patient reported four coloured dots, this indicated a normal and expected response. Reporting two red dots or three green dots was considered as a suppression response. All participants underwent an ocular health examination using a slit lamp biomicroscope by an ophthalmologist. The posterior segment examination was undertaken by indirect ophthalmoscopy using a + 90 D lens.