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    874 results match your criteria American Orthoptic Journal[Journal]

    1 OF 18

    Congenital Cranial Dysinnervation Disorders: A Literature Review.
    Am Orthopt J 2017 Jan;67(1):89-92
    From the Clinical Vision Science Faculty of Health, IWK Health Centre Eye Clinic, Dalhousie University, Halifax, Nova Scotia, Canada.
    Congenital cranial dysinnervation disorders (CCDD) is a new term describing a collection of non-progressive neurogenic syndromes. Initially referred to as congenital fibrosis syndrome, it was thought that the primary problem was extraocular muscular maldevelopment. Recent advancements in genetics and neuro-radiology have now determined the initial observation of fibrotic muscles is secondary to a primary lack of innervation from deficient, absent, or misguided cranial nerves. Read More

    Early Onset Sixth-Nerve Palsy with Eccentric Fixation.
    Am Orthopt J 2017 Jan;67(1):72-79
    From the Eye Center, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania;
    Purpose: To report four cases of early onset sixth-nerve palsy all of whom had eccentric fixation.

    Methods: A retrospective case note review was undertaken of all cases presenting to the senior author's private and NHS practice with early onset sixth palsy between 2006 and 2012. As well as demographic information, details of ophthalmic, orthoptic, electrophysiological examinations, and radiological investigations that were extracted from the records. Read More

    Two Orthoptic Treatments in Dragged-Fovea Diplopia Syndrome.
    Am Orthopt J 2017 Jan;67(1):67-71
    From the Neuromusculoskeletal Department, Eye Clinic, University of Florence, Florence, Italy.
    Background: "Dragged-fovea diplopia syndrome" is a type of central binocular diplopia that is secondary to a foveal displacement, caused by epiretinal membranes (ERMs) or other macular diseases. Its management is difficult, because prisms are not effective.

    Case Reports: Two cases of dragged-fovea diplopia syndrome were presented. Read More

    Anterior Segment Optical Coherence Tomography of Previously Operated Extraocular Muscles.
    Am Orthopt J 2017 Jan;67(1):61-66
    Ross Eye Institute, University at Buffalo, Department of Ophthalmology, Buffalo, New York.
    Background And Purpose: To assess the possibility of determining the insertion distance from the limbus of previously operated extraocular rectus muscles (EOM) with the Heidelberg Spectralis anterior segment optical coherence tomography (AS-OCT).

    Patient And Method: Subjects with a history of previous strabismus surgery underwent AS-OCT of the EOM before planned additional strabismus surgery. The EOM insertion distances from the limbus were measured pre-operatively on the AS-OCT and compared to the caliper distance measured during the strabismus surgery. Read More

    Everyday Exotropia: Learning from the Littlest.
    Am Orthopt J 2017 Jan;67(1):52-60
    From Children's Eye Care, Children's Hospital of Michigan, Detroit, Michigan.
    Background And Purpose: Early onset exodeviations in systemically and ocularly healthy young children, diagnosed at less than 1 year of age, may be of the constant, "infantile XT" type, or early X(T) type. The onset of common childhood X(T) is not clearly known. The purpose of this lecture is to discuss theories and characteristics of early onset exodeviations, and report on our observations of infantile XT and early X(T) at Children's Eye Care in Michigan. Read More

    Modified Test Protocol Improves Sensitivity of the Stereo Fly Test.
    Am Orthopt J 2016 Jan;66(1):122-125
    From the Retina Foundation of the Southwest;
    Background And Purpose: Stereoacuity measurement is a common element of pediatric ophthalmic examinations. Although the Stereo Fly Test is routinely used to establish the presence of coarse stereopsis (3000 arcsecs), it often yields a false negative "pass" due to learned responses and non-stereoscopic cues. We developed and evaluated a modified Stereo Fly Test protocol aimed at increasing sensitivity, thus reducing false negatives. Read More

    A Clinical Randomized Trial Comparing the Cycloplegic Effect of Cyclopentolate Drops Applied to Closed Eyelids Versus Open Eyelids.
    Am Orthopt J 2016 Jan;66(1):114-121
    Department of Ophthalmology, College of Medicine, University of Saskatchewan, Saskatchewan, Canada.
    Background And Purpose: Adequate cycloplegia and dilation are required for refraction and fundus exam in children. Standard practice is to instill cycloplegic drops in the inferior cul-de-sac, and this is often traumatic for children. Our study assesses the use of cyclopentolate on closed lids as a method of instillation for ensuring complete cycloplegia. Read More

    Association Between Ocular Dominance and Anisometropic Hyperopia.
    Am Orthopt J 2016 Jan;66(1):107-113
    From the Department of Ophthalmology, Kitasato University Hospital, Kanagawa, Japan.
    Introduction And Purpose: Anisometropia, a relative difference in the refractive state of the two eyes, is common in hyperopic patients. We investigated the association between ocular dominance (sighting dominance) and refractive asymmetry in patients with hyperopia.

    Methods: This retrospective study included 223 hyperopic patients with a mean age of 10. Read More

    Accuracy and Efficiency of Orthoptists in Comprehensive Pediatric Eye Examinations.
    Am Orthopt J 2016 Jan;66(1):98-106
    From the School of Allied Health, La Trobe University, Victoria, Australia.
    Introduction And Purpose: To investigate the level of agreement between orthoptists and medical practitioners in the comprehensive eye examination of children seen in an orthoptist-led triage clinic.

    Patients And Methods: Patient records over a 6-month period were retrospectively reviewed. Those with a presenting complaint related to vision or ocular motility were triaged into the orthoptist-led clinic and included in the study. Read More

    Binocular Vision in Chronic Fatigue Syndrome.
    Am Orthopt J 2016 Jan;66(1):92-97
    From the Antwerp University Hospital, Department of Ophthalmology, Edegem (Antwerp).
    Introduction And Purpose: To compare binocular vision measurements between Chronic Fatigue Syndrome (CFS) patients and healthy controls.

    Methods: Forty-one CFS patients referred by the Reference Centre for Chronic Fatigue Syndrome of the Antwerp University Hospital and forty-one healthy volunteers, matched for age and gender, underwent a complete orthoptic examination. Data of visual acuity, eye position, fusion amplitude, stereopsis, ocular motility, convergence, and accommodation were compared between both groups. Read More

    Efficacy of an Amblyopia Treatment Program with Both Eyes Open: A Functional Near-Infrared Spectroscopy Study.
    Am Orthopt J 2016 Jan;66(1):87-91
    Department of Ophthalmology, School of Medicine, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Japan.
    Introduction And Purpose: To investigate the efficacy of an amblyopia treatment program with both eyes open.

    Methods: Ten subjects (mean age 20.5 ± 1. Read More

    Surgical Management of Unilateral Superior Oblique Palsy: Thirty Years of Experience.
    Am Orthopt J 2016 Jan;66(1):79-86
    From the Department of Ophthalmology, University of Montreal, Montreal, Quebec;
    Introduction And Purpose: We describe the clinical characteristics of 252 patients with unilateral superior oblique palsy who underwent strabismus surgery. We assess if a predetermined surgical strategy, based on preoperative alignment and motility measurements, was effective in treating these patients. On this basis, the patients were divided into three different treatment groups. Read More

    Planning Strabismus Surgery: How to Avoid Pitfalls and Complications.
    Am Orthopt J 2016 Jan;66(1):63-78
    From the British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
    Background And Purpose: Good surgical results following strabismus surgery depend on several factors. In this article, detailed steps for planning strabismus surgery will be reviewed for basic horizontal strabismus surgery, vertical, and oblique muscle surgeries. The thought process behind each case will be presented to help in selecting the best surgical approach to optimize postoperative results. Read More

    The Necessity of Amblyopia.
    Am Orthopt J 2016 Jan;66(1):53-62
    From the W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.
    A general property of nervous system development is that correlated activity is used to organize topographic projections. This correlated activity is typically produced by electrical coupling of adjacent neurons; however, electrical coupling is not possible for retinal ganglion cells in separate eyes that need to be precisely mapped to the same place in the brain. This forces the visual system to rely on environmental stimuli to produce the correlated activity that drives the development of binocularity, with amblyopia as necessary consequence when visual experience is abnormal. Read More

    High AC/A Ratio Esotropia: Do We Really Need to Be Using Bifocals?
    Am Orthopt J 2016 Jan;66(1):5-9
    From Children's Mercy Hospital, Kansas City, Missouri.
    Introduction And Purpose: Most strabismus specialists use bifocals for patients with convergence excess esotropia whose distance deviation is small. While this is a popular treatment modality, there is actually no good data to indicate that this should be considered a standard of care.

    Patients And Methods: In patients for whom the distance deviation is small enough to allow for the development of binocular vision, my preference is to simply observe these patients. Read More

    Accommodative ET-High AC/A Ratio Esotropia: The Case for Glasses.
    Am Orthopt J 2016 Jan;66(1):1-4
    From the Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York.
    Background And Purpose: There is a continuing debate as to whether the patient optically correctable at distance to within 8 prism diopters of perfect alignment requires treatment for persisting overconvergence at near, and if treatment is indicated, what it should be.

    Patients And Methods: For the patient whose misalignment at distance is reduced to 8 or fewer prism diopters, my preference is for the full cycloplegic correction plus a bifocal in the first prescription, to discourage virtually all accommodation initially, with pull back later.

    Results: Review of several reports indicates a continued lack of consensus on whether this causes disuse weakening of accommodation and premature presbyopia. Read More

    A Case Series: Exercise-Induced Esotropia.
    Am Orthopt J 2015 ;65:115-20
    From the Johns Hopkins University School of Medicine, Baltimore, Maryland; From the The Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland.
    The authors present three patients with idiopathic exercise-induced esotropia. The history, physical findings, and testing that led to the diagnosis are discussed. To the authors' knowledge, this is the largest series of patients with this rare condition, with this series representing half of reported patients in the literature. Read More

    A Case Report: Consecutive Cranial Neuropathies Following the Use of Phosphodiesterase-5 Inhibitors.
    Am Orthopt J 2015 ;65:109-14
    From the Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
    We report a patient who suffered consecutive cranial neuropathies where each event was immediately preceded by the use of oral PDE-5 inhibitors. A discussion of the etiology of the events including possible interaction with other medications is included. Read More

    Wernicke Encephalopathy.
    Am Orthopt J 2015 ;65:104-8
    From the Neuro-Ophthalmology of Texas Medical Clinic, Houston, Texas.
    Introduction And Purpose: This paper reviews the complaints and associated symptoms/consequences of lacking essential nutrients and vitamins in our central and peripheral nervous systems. This has become important as there has been a rise in malnutrition following the increasing incidence of bariatric surgery for obesity.

    Methods: A case report example involving review of the clinical presentation and treatment. Read More

    Is The Convergence Insufficiency Symptom Survey Specific for Convergence Insufficiency? A Prospective, Randomized Study.
    Am Orthopt J 2015 ;65:99-103
    From the Eye Specialists Center, Chicago Ridge, Illinois.
    Background And Purpose: The Convergence Insufficiency Symptom Survey (CISS) is a questionnaire used as an outcome measure in treatment of convergence insufficiency. The current prospective randomized trial evaluates the diagnostic specificity of the CISS.

    Patients And Methods: Surveys were completed by 118 adolescent patients who presented for routine eye examinations. Read More

    Comparing Visual Acuity Measured by Lea Symbols and Patti Pics.
    Am Orthopt J 2015 ;65:94-8
    From the Family Eye Group, Lancaster, Pennsylvania and.
    Introduction: There is little data validating most illiterate eye charts. Lea Symbols®, however, have been well validated in numerous studies. In this study, we compare the assessment of visual acuity employing both the Lea Symbol hanging wall Early Treatment Diabetic Retinopathy Study (ETDRS)-style chart and a similar Patti Pics® ETDRS-style chart in order to determine whether the two charts provide clinically similar data. Read More

    Residual Strabismus in Children Following Improvement of Cranial Nerve Palsies Affecting Ocular Ductions.
    Am Orthopt J 2015 ;65:87-93
    From the Hamilton Eye Institute, Department of Ophthalmology, University of Tennessee Health and Science Center, Memphis, Tennessee; From the Department of Oncology, St. Jude Children's Research Hospital, Memphis and.
    Background: Children with brain neoplasms often develop cranial nerve palsies (CNP) affecting ocular ductions. Duction deficits may improve or resolve with treatment of their intracranial disease. However, these children may be left with residual strabismus. Read More

    Unmasking Bilateral Inferior Rectus Restriction in Thyroid Eye Disease: Using Degree of Cyclotropia.
    Am Orthopt J 2015 ;65:81-6
    From the Ross Eye Institute, University at Buffalo, Buffalo, New York.
    Purpose: Thyroid eye disease (TED) frequently causes strabismus and diplopia. Though the condition involves multiple extraocular muscles in both eyes, the inferior rectus (IR) muscle is particularly susceptible. TED may be so asymmetric as to mask the involvement of the contralateral IR. Read More

    Tenacious Proximal Fusion: The Scobee Phenomenon.
    Am Orthopt J 2015 ;65:73-80
    From the Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin.
    Background And Purpose: When patients with intermittent exotropia show an increase in their near deviation after prolonged monocular occlusion, they have been said to have tenacious proximal fusion (TPF). That term is not adequately descriptive, since this finding can occur without the patient having been allowed to fuse. The purpose of this study is to investigate the possibility that this phenomenon is mediated by the preponderance of binasal retinal disparity and uncrossed localization that occurs with near fixation. Read More

    Evaluation of Sensory Dominance Using Binocular Rivalry as Related to Ocular Deviations.
    Am Orthopt J 2015 ;65:67-72
    From the Department of Orthoptics and Visual Science, School of Health Science, International University of Health and Welfare, Tochigi, Japan.
    Introduction And Purpose: To investigate the relationship between sensory dominance and ocular deviations.

    Patients And Methods: Sixty-three patients were evaluated with a new device for the measurement of exclusive visibility during binocular rivalry. The patients were consisted of twenty-three with exotropia (XT), twenty with intermittent exotropia [X(T)], twenty with exophoria (XP), respectively. Read More

    Congenital and Genetic Ocular Motility Disorders: Update and Considerations.
    Am Orthopt J 2015 ;65:58-66
    From the IWK Health Centre Eye Care Team, Halifax, Nova Scotia, Canada; From the Faculty of Health Professions, Dalhousie University, Halifax, Nova Scotia, Canada; From the Division of Ophthalmology, Faculty of Health Sciences, University of Stellenbosch, Tygerberg, South Africa.
    Concepts regarding certain forms of congenital eye movement disorders have recently changed, due in large part to new genetic evidence identifying causative genes and their role in the development of extraocular muscle innervation. This group is now referred to as the Congenital Cranial Dysinnervation Disorders (CCDDs). Careful assessment of phenotypic features that include both ophthalmological and non-ophthalmological features in genetically defined individuals has led to the development of a more robust classification system. Read More

    Sensorimotor Characteristics of Neuro-Ophthalmology and Oculo-Plastics Patients.
    Am Orthopt J 2015 ;65:47-57
    From the Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland.
    Background And Purpose: Certified orthoptists are routinely required, as a standard component of outpatient care, to examine and identify the cause of double vision described by neuro-ophthalmology and oculo-plastics patients. Peer-reviewed articles in the strabismus literature describing the significance of this role of the orthoptists, especially in more complex cases of strabismus, do exist, but are outdated. The importance of creating a differential diagnosis in the understanding of the disease process is a well-recognized component of medical education and modern medicine. Read More

    Prism Management in Patients with Neurodegenerative Disease.
    Am Orthopt J 2015 ;65:44-6
    From the Sarasota Retina Institute, Sarasota, Florida.
    Patients with motility problems due to neurodegenerative disease such as Parkinson's and its variations often present challenging cases for the orthoptist. A few "tricks of the trade" will be presented on how to make a Parkinson's patient's daily life a little easier. Read More

    Evaluation and Prism Management of Divergence Insufficiency Esotropia.
    Am Orthopt J 2015 ;65:40-3
    From the W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.
    An esodeviation that is greater at distance than near in an adult patient requires a full sensorimotor exam to rule out any cofounding neurological conditions. Many etiologies are described in the literature to cause an esodeviation that is greater at distance than near in adult patients and some exist in conjunction with a neurological condition. However, many adult patients present to the adult strabismus clinic with no other findings on exam and have a purely benign divergence insufficiency esotropia. Read More

    Divergence Insufficiency Esotropia: Surgical Treatment.
    Am Orthopt J 2015 ;65:35-9
    From the Jules Stein Eye Institute, University of California-Los Angeles, Los Angeles, California.
    Divergence insufficiency esotropia, or acquired comitant esotropia that is at least 10Δ larger at distance than at near, is most often seen in older adults, and may also be known as "age-related distance esotropia." Surgical treatment is often indicated for patients who do not tolerate prism therapy, or for those with large angles of esotropia. Surgical treatments have evolved with our understanding of the disease-state. Read More

    Small Deviations: Vertical, Horizontal, and Combined.
    Am Orthopt J 2015 ;65:31-4
    From the W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.
    Introduction And Purpose: Symptomatic, small-angle strabismus is largely an acquired problem of adults that has previously been managed with prism spectacles. This paper will explore surgical options that are becoming increasingly popular.

    Methods: The special issues that confound surgical treatment of small-angle strabismus are considered. Read More

    Macular Diplopia.
    Am Orthopt J 2015 ;65:26-30
    From The New York Eye and Ear Infirmary of the Mount Sinai Health System, New York, New York.
    Maculopathies affect point-to-point foveal correspondence causing diplopia. The effect that the maculopathies have on the interaction of central sensory fusion and peripheral fusion are different than the usual understanding of treatment for diplopia. This paper reviews the pathophysiology of macular diplopia, describes the binocular pathology causing the diplopia, discusses the clinical evaluation, and reviews the present treatments including some newer treatment techniques. Read More

    Torsional Diplopia.
    Am Orthopt J 2015 ;65:21-5
    From Houston Eye Associates, The Woodlands, Texas.
    Background And Purpose: Torsional diplopia can result in failure of fusion in an individual without a measureable strabismus. When presented with a patient with complaints of binocular diplopia, physicians and orthoptists should consider cyclovertical muscle dysfunction when the source of the complaint is not readily apparent.

    Methods: A thorough review of the literature combined with the author's own personal experience in treating adult patients with strabismus was used to evaluate the different potential causes of torsional diplopia. Read More

    Pediatric Ophthalmology Practice Efficiency: Utilization of Orthoptists as Partners in the Pediatric Eye Care Team.
    Am Orthopt J 2015 ;65:9-13
    From Houston Eye Associates, The Woodlands, Texas.
    Background And Purpose: The profession of orthoptics has been present for over 100 years and was created as a partnership with pediatric ophthalmology in an effort to provide better strabismus care to children. Orthoptists are known to improve practice efficiency, but to date, no quantitative data has been presented in the literature to support this claim. Proper utilization of an orthoptist is critical to improving practice efficiency and revenue. Read More

    A History of Orthoptics in the United States, Part I: "If You Build It, They Will Come".
    Am Orthopt J 2015 ;65:1-8
    From the Ross Eye Institute, University of Buffalo, Buffalo, New York.
    The year 2015 marks the 75th anniversary of the American Association of Certified Orthoptists (AACO), the second oldest orthoptic professional organization in the world. Since its inception, October 7, 1940, approximately 90% of all certified orthoptists (C.O. Read More

    Silent sinus syndrome presenting after a roller coaster ride: a case report.
    Am Orthopt J 2014 ;64:123-5
    Family Eye Group, Lancaster, Pennsylvania.
    This is a case presentation of a 39-year-old male who presents with silent sinus syndrome. He was initially diagnosed by a neuroophthalmologist, and at first, the patient's otolaryngologist disagreed. The patient had a significant reduction in his symptoms with surgical and orthoptic intervention. Read More

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