1/4. Accommodative and vergence findings in ocular myasthenia: a case analysis.myasthenia gravis (MG) is a neuromuscular disorder that affects skeletal muscles, in particular, the extraocular muscles. Response variability is a hallmark sign. Detailed findings are described in a patient with MG in which the presenting sign was accommodative insufficiency. Objective accommodative findings were recorded 3 years before the onset of myasthenia, soon after the initial diagnosis was made, and then after the treatment commenced with pyridostigmine. In addition, clinical measurements were obtained periodically at different times of the day for various binocular motor functions, including near point of convergence, phoria, fusional and accommodative amplitudes, and relative accommodation. The disease adversely affected all accommodative and vergence findings, with fatigue being the primary disturbance. The therapeutic administration of pyridostigmine improved static measurements of accommodation and vergence and reduced asthenopia. The objective dynamic measurements of accommodation, vergence, and versions were less affected. These findings provide a clear demonstration that both intrinsic and extrinsic ocular muscles may be affected in the prepresbyopic myasthenic patient.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
2/4. Duane's retraction syndrome and the relief of secondary torticollis and near point asthenopia with prism.A young woman presented with complaints of reading difficulty. An examination revealed that the patient had Duane's Retraction syndrome--Type III, which affected her right eye. We prescribed yoked prism base left and additional base-in prism for the right eye in a successful attempt to alleviate the patient's symptoms.- - - - - - - - - - ranking = 4keywords = near (Clic here for more details about this article) |
3/4. Accommodation deficiency in healthy young individuals.Ten patients, ages 10 to 19, with accommodation insufficiency are reported. All patients were in good health and asymptomatic, except for asthenopia during near visual activities. Each patient's amplitude of accommodation was measured and found to be considerably below the minimal normal for their respective ages (an average of 6 diopters). Only three patients had associated convergence insufficiency. No etiology for the diminished accommodation was suggested by history or could be identified by careful examination. All patients were successfully managed optically with bifocals or reading glasses, although three required the addition of base-in prisms for the near exodeviation. Near vision testing and determination of the near point of accommodation should be part of the pediatric ophthalmologic examination in all patients with complaints referable to their reading and visual performance at near.- - - - - - - - - - ranking = 4keywords = near (Clic here for more details about this article) |
4/4. Convergence amplitude insufficiency.There is a frequently overlooked group of patients, usually under 20 years of age, with typical symptoms of convergence insufficiency and diminished convergence amplitudes, but with normal near point of convergence. We studied ten cases of this type, which we call convergence amplitude insufficiency. The diagnosis in such patients will not be missed if convergence amplitudes are measured on every patient complaining of asthenopic symptoms during close work.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |