1/9. Deterioration of accommodative esotropia during part-time occlusion therapy.The authors report two cases of suddenly deteriorated accommodative esotropia with amblyopia during part-time occlusion therapy. A 7-year-old girl with right accommodative esotropia, which was well controlled, showed marked increase in esodeviation after part-time occlusion and regained orthophoria without occlusion. This phenomenon was repeated. Recession of both medial recti was performed and orthophoria was well maintained at both distant and near targets. Accommodative esotropia of a 9-year-old boy with glasses also showed a striking increase in esodeviation after part-time occlusion. The authors recommended wearing only glasses without occlusion or surgery and he recovered fusion. Three months later, orthophoria was maintained at distant target, with 8PD esophoria at near target with glasses. Although this complication should be considered before occlusion therapy, it must be taken continuously if needed, because an increase of the deviation size with occlusion may simply reflect a true deviation and may not be a poor prognostic sign.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
2/9. diagnosis and management of accommodative esotropia.BACKGROUND: Accommodative esotropia is the most common form of childhood strabismus presenting to optometric practice. Functional and cosmetic outcomes are often excellent but depend on accurate diagnosis, urgent and correct initial management and careful follow-up. case reports: We present several cases that highlight important aspects of the clinical care of accommodative esotropia. The first patient was mismanaged by undercorrection of hypermetropia, but was later accurately diagnosed to have accommodative esotropia and was subsequently managed successfully with full hypermetropic correction alone. The second patient had an accommodative esotropia with amblyopia. The third patient used a near addition to correct a residual near esotropia. CONCLUSIONS: The published evidence and these cases make several points regarding assessment, diagnosis and management of esotropia. Assessment must aim to reach a diagnosis based on aetiology, as the aetiology of esotropia has a significant impact on management decisions and prognosis.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
3/9. Eight cases of congenital achromatopsia with amblyopia in two pedigrees from Northern sweden.Two families from northern sweden with a total of 8 patients with typical symptoms of congenital achromatopsia with amblyopia were studied. In one of the families 4 affected children (3 brothers and 1 sister) also showed pallor of the optic discs and marked astigmatism. The transmission of the disease was consistent with an autosomal recessive inheritance in both families. The study confirmed that complete and incomplete achromatopsia might be different expressions of the same gene. Six out or 13 near relatives of the achromatic patients showed minor colour vision defects, suggesting a tendency towards heterozygotic manifestation of the gene.- - - - - - - - - - ranking = 0.5keywords = near (Clic here for more details about this article) |
4/9. Preferential looking as a guide for amblyopia therapy in monocular infantile cataracts.Despite recent advances in surgical technique and refractive correction, amblyopia remains a significant problem in the treatment of monocular infantile cataracts. amblyopia therapy recommended by different authors during the preverbal period has varied from no patching to nearly full-time occlusion of the phakic eye. We measured preferential looking (PL) acuities sequentially in four infants following monocular cataract surgery and contact lens correction. This information was used to adjust occlusion of the phakic eye, which was prescribed 25%-100% of waking hours. Patching schedules were altered, on average, every three to four months in response to changes in PL acuities. Four increases in patching intensity retarded acuity development in the phakic and benefited development in the aphakic eyes. Nine decreases enhanced progress or yielded no change in the phakic and, with two exceptions, impeded progress in the aphakic eyes. Recognition acuities now available for two of the children show continuity with previous PL acuities and confirm useful vision in the aphakic eyes. We describe guidelines for adjusting occlusion based on our experience. We believe that PL modulation of patching therapy may result in more favorable visual outcomes for both eyes of infants with monocular cataracts.- - - - - - - - - - ranking = 0.5keywords = near (Clic here for more details about this article) |
5/9. Penalization in the treatment of amblyopia.Penalization is a useful alternative to occlusion therapy in amblyopia of mild and moderate degrees and in preserving therapeutic gains made by previous occlusion treatment. Penalization at near, total, and alternating penalization are more valuable than penalization at distance. Because penalization does not prevent the development of visual deprivation amblyopia, unilateral atropine therapy must be used carefully in treating patients in an age group susceptible to occlusion amblyopia.- - - - - - - - - - ranking = 0.5keywords = near (Clic here for more details about this article) |
6/9. strabismus in the aphakic patient.Fifty patients with aphakia and strabismus were studied. The chief complaint was diplopia following full optical correction. Prism therapy was recommended if the diplopia persisted after 3 to 4 months. When prism therapy was ineffective or impractical, surgery was recommended. The result of therapy was not influenced by the cause of the cataract treatment was considered successful in approximately 80% of patients. patients who had convergence insufficiency did well with prism therapy alone. Half of the patients who had divergence excess needed extraocular-muscle surgery. One fourth of the patients had esotropia, nearly half associated with lateral rectus palsy. While prism therapy resulted in fusion, a reduction in prism power was not tolerated in this group. For this reason, surgery was suggested for all patients who had esotropia.- - - - - - - - - - ranking = 0.5keywords = near (Clic here for more details about this article) |
7/9. Oculomotor biofeedback therapy for exotropia.Twelve exotropes of various types received oculomotor biofeedback therapy at State College of new york (SUNY) University Optometric Center. feedback of a variable pitch tone which reflected changes in ocular vergence reinforced motor control of eye posture. patients were trained to achieve and sustain alignment in a variety of viewing situations. The six intermittent exotropes in the study who did not have amblyopia or prior history of unsuccessful surgical or orthoptic therapy achieved the highest recovery rating after training. The amblyope and those who had orthoptic training learned to voluntarily correct their eye position, although they did not achieve as acute a sensitivity to loss of alignment as did the others. Therapy restored eye control at near in a young constant exotrope whose condition resulted from severe neurological dysfunction. A constant postsurgical exotrope who had no ability for sensory fusion made little progress. Advantages of oculomotor biofeedback therapy are shorter treatment time, elimination of lengthy home training exercises, and enhanced patient motivation.- - - - - - - - - - ranking = 0.5keywords = near (Clic here for more details about this article) |
8/9. Nutritional amblyopia associated with jejunoileal bypass surgery.After jejunoileal bypass surgery for morbid obesity, metabolic complications including a nutritional amblyopia developed in a patient. Reanastomosis of the bypass and treatment with multivitamins resulted in a nearly complete return of vision. Any patient undergoing rapid weight loss after gastrointestinal surgery for morbid obesity should be followed up for possible decrease in vision. If nutritional amblyopia develops, immediate reversal of the previous surgery is indicated.- - - - - - - - - - ranking = 0.5keywords = near (Clic here for more details about this article) |
9/9. Malignant transformation of a necrotic melanocytoma of the choroid in an amblyopic eye.A 26-year-old man presented with an insidious loss of vision OD. He had amblyopia OD as a child secondary to congenital esotropia. Ophthalmic examination revealed a large mass beneath his right retina near the posterior pole. He also had glaucoma and a rapidly developing cataract. Ultrasound detected a choroidal mass, which was consistent with a melanoma. The patient chose enucleation over radiation therapy as his treatment modality. Pathologic evaluation of the tumor revealed a necrotic melanocytoma with a large malignant melanoma arising from its center that was comprised mainly of epithelioid cells. Malignant melanoma arising in a necrotic melanocytoma is an extremely rare event, and we believe this to be the first description of this event in a young patient with an amblyopic eye.- - - - - - - - - - ranking = 0.5keywords = near (Clic here for more details about this article) |