Cases reported "Hyperopia"

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1/9. Abnormal head posture associated with high hyperopia.

    BACKGROUND: An abnormal head posture may be adopted for ocular or nonocular reasons. The most common ocular reasons are to maintain binocularity and to obtain the best possible visual acuity. patients with undercorrected or overcorrected refractive errors have been reported to adopt a variety of head positions, thought to be an attempt to obtain the best possible visual acuity. methods: Five patients with symmetric high hyperopia (at least 5.00 D) and an abnormal head posture are presented. RESULTS: All five patients demonstrated an abnormal head posture of chin down for fixation without the spectacle correction in place. This abnormal head posture was eliminated by occlusion of either eye and also by wearing of the refractive correction. No patient demonstrated significant strabismus. CONCLUSION: An abnormal head posture when not wearing spectacle correction can occur in children who have high hyperopia and insignificant strabismus. This may be a mechanism by which the best visual acuity is obtained (indicated by the disappearance of the abnormal head posture on wearing of the glasses) and also to maintain binocularity (indicated by the disappearance of the abnormal head posture under monocular testing conditions). The presence of a chin-down abnormal head posture should alert the examiner to the possible presence of high hyperopia and therefore the necessity for a cycloplegic refraction.
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ranking = 1
keywords = strabismus
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2/9. Ocular components before and after acquired, nonaccommodative esotropia.

    BACKGROUND: Acquired nonaccommodative esotropia describes the sudden onset of a constant, comitant strabismus of idiopathic origin in children >6 months of age. CASE REPORT: We present a case of acquired nonaccommodative esotropia at 20 months of age in a subject participating in the Berkeley infant biometry Study, a longitudinal study of emmetropization and ocular component development in infants between 3 months and 3 years of age. Ocular components for this child were normal before the onset of strabismus (within 2 SD's of the mean for orthotropic study participants) for refractive error, corneal power, lens radii, lens power, and ocular axial dimensions. Refractive error postsurgically was significantly more hyperopic and crystalline lens power lower than average at 2.38 D and 37.2 D, respectively. CONCLUSIONS: The lack of abnormal ocular parameters is consistent with the idiopathic etiology of acute onset esotropia. This case suggests that ocular component values may not be useful for assessing the risk of acquired nonaccommodative esotropia.
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ranking = 1
keywords = strabismus
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3/9. presbyopia complicating pre-existing strabismus.

    BACKGROUND: presbyopia may affect pre-existing sensory adaptations or aggravate previously asymptomatic heterophoria. We describe the presentation, underlying problem and management of 11 patients with pre-existing strabismus or heterophoria who presented with new symptoms of double vision attributable to presbyopic change, an association not previously reported. methods: patients with new strabismic symptoms attributable to presbyopia were recruited prospectively over a 1-year period. RESULTS: The 11 patients had had a recent decrease of accommodative amplitude that resulted in blurred vision at near with a breakdown of pre-existing heterophoria (2 patients), alteration of fixation pattern (6 patients), symptomatic alternating fixation (2 patients) or intolerance to correction owing to restrictive strabismus (1 patient). INTERPRETATION: At the onset of presbyopia, symptoms may be varied and subtle. Ophthalmologists and orthoptists should carefully determine the exact nature of the symptoms. Any pre-existing fixation pattern should then be established from the history, old photographs or suppression characteristics. Refractive or surgical management should be aimed at returning the patient to his or her long-standing sensory adaptation. Other important issues, such as incomplete correction of hypermetropia by refractive surgery and problems using bifocals with vertical restrictive strabismus, should be noted.
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ranking = 3.5
keywords = strabismus
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4/9. Optometric management of optically induced consecutive exotropia.

    A 5-1/2 year old black female initially presenting with a moderate angle esotropia and latent hyperopia developed a large angle constant exotropia 2 years after final correction of her refractive error. The occurrence of consecutive exotropia as a result of optical correction of hyperopia has been documented infrequently in the ophthalmologic literature and has rarely been mentioned in the optometric literature. While the overall risk for occurrence of this complication from correction of hyperopia may be small, it is a problem which may occur and can be avoided. Unfortunately, there is only limited information about the various risk factors that should be monitored to avoid the occurrence of an optically induced consecutive exotropia. What is available with regard to evaluation and management is scant, and there are no case reports emphasizing optometric management which includes the use of lenses, occlusion and vision therapy. The purpose of this paper is to present a case report of optically induced consecutive exotropia followed by a summary of the available information from the optometric and ophthalmologic literature. This combined information will aid optometrists managing these patients to avoid the occurrence of this problem and better understand the various management aspects when it does occur.
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ranking = 21.685339229475
keywords = exotropia
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5/9. Form vision deprivation amblyopia: further observations.

    Nine cases of esotropia occurring in deprivation amblyopia, where exotropia rather than esotropia is usually found, showed a refractive error of hypermetropia. This fact suggested that an accommodative factor is largely responsible for the development of esotropia. A- or V-pattern strabismus was encountered in a higher incidence in deprivation amblyopia than in ordinary strabismus. Pattern-reversal VEP showed more prominent abnormality than flash VEP did. Studies of the sensitive period of the visual system revealed that the sensitivity is likely to be low for a month or two after birth and increases with a peak around the 18th month of age, decreasing thereafter with a waning slope to the end of the 8th year of life.
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ranking = 3.7106674036844
keywords = exotropia, strabismus
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6/9. Children with exotropia responsive to spectacle correction of hyperopia.

    A series of seven exotropic children (aged 2 to 10 years) had resolution of exotropia after spectacle correction of hyperopia. Their hyperopic correction ranged from 3.00 to 7.00 diopters. Six had intermittent exotropia, which became small-angle esophoria after spectacle correction. In one patient with apparently no fusion, spectacle correction converted constant exotropia to small esotropia in the monofixational range. In all patients, Worth 4-dot and Titmus Stereo Test results, when obtainable, indicated an improvement in binocular sensory status after correction of the hyperopia. We conclude that a trial of spectacle correction is warranted in exotropic children with severe hyperopia and in those with moderate hyperopia and a low accommodative convergence/accommodation ratio or evidence of hypoaccommodation.
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ranking = 18.974671825791
keywords = exotropia
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7/9. angelman syndrome.

    BACKGROUND: Angelman (happy puppet) syndrome is a neuro-developmental condition characterized by an ataxic gait with puppet-like limb movements, paroxysmal bouts of laughter and severe mental retardation. Although considered a rare condition, over 140 cases have been documented since its designation in 1965. To date, only one study has been published investigating the ocular defects of angelman syndrome. methods: In this paper we report the cognitive, motor, systemic, and oculo-visual findings of a 3 year old child with angelman syndrome. RESULTS: The oculo-visual findings include choroidal hypopigmentation, iris hypopigmentation, strabismus, and hyperopia. CONCLUSIONS: As in many neuro-developmental conditions, early diagnosis is crucial. The ocular findings of fundal/iris hypopigmentation and strabismus with minimal refractive error in conjunction with the cognitive, behavioral, and motoric characteristics the patient exhibits may be the first clues for the diagnosis of angelman syndrome in a developmentally delayed child. The initiation of individualized optometric diagnosis and treatment is important for all children with developmental disabilities. The eye care professional should work in concert with speech, occupational, and physical therapists, neurologists, and special educators in the multi-disciplinary treatment and habilitation of all children with disabilities including those with angelman syndrome.
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ranking = 1
keywords = strabismus
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8/9. Aarskog syndrome associated with hypermetropia and toe anomaly.

    Aarskog syndrome is characterised by a disproportionately short stature and facial, skeletal and urogenital anomalies ('shawl' scrotum and cryptorchidism). Ophthalmic findings include a slight downward slant to the palpebral fissures, hypertelorism, blepharoptosis, strabismus, ophthalmoplegia, hypermetropic astigmatism and a large cornea. Findings on the extremities include joint hyperextensibility, short and broad hands, interdigital webbing, a short fifth finger, clinodactyly and broad feet with bulbous toes. We report on a 7 1/2-year-old boy with typical findings of Aarskog syndrome, hypermetropia and bilateral proximal implantation of the fifth toes. These associated abnormalities have hitherto never been described, to our knowledge.
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ranking = 0.5
keywords = strabismus
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9/9. Transposition of vertical recti for residual tropias.

    Transposition of vertical muscles for residual tropia was performed: nasal displacement for exotropia and temporal displacement for esotropia. Five millimeter equal displacement of superior and inferior recti corrected 10 to 14 prism diopter while equal displacement of 7 to 8 mm resulted in correction of 25 prism diopter. Special indications of this procedure may be: (1) residual tropia in cases with severe intractable ambylopia or pathology in one eye where patient and surgeon may be reluctant to operate on the sound eye, or (2) residual tropias of the alternating type in patients who underwent operations in all horizontal muscles of both eyes.
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ranking = 2.7106674036844
keywords = exotropia
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