The Change of Sensory Binocularity according to the Surgical Results in Intermittent Exotropia

PURPOSE: This study was designed to determine which sensory test best reflects the improvement of binocular function according to the surgical outcome of intermittent exotropia METHODS: We examined the visual acuity, refractive error, angle of exodeviation, fusional status with the Worth-4-dot, Bagolini tests and stereoacuity with the Titmus test preoperatively in 61 intermittent exodeviation patients who had undergone the bilateral lateral rectus recession operation from February 2002 to 2003 July. We compared the binocularity tests between the two groups: esodeviated and orthotropic or exodeviated. RESULTS: The average improvement time of the Bagolini, Worth 4 dot and Titmus tests was 0.54 +/- 1.2, 2.03 +/- 2.90, 1.12 +/- 2.1 weeks, respectively. Although the shortest time was for the Bagolini test (p=0.001), the Titmus test was more sensitive. CONCLUSIONS: The high variability of the binocularity tests should be remembered and take into account when we interpret the test results.

Artifact of Worth Four Dot Test in Strabismic Patients

It is the purpose of this study to evaluate fusional status of 49 strabismic patients who showed orthophoria less than 10 prism diopters (PD) after surgery under alternate prism and cover test. We undertook the Worth 4-dot(W4D) test twice, reversing the position of the red/green glasses between the eyes for the second trial. Bagolini test was also performed in 31 of 49 cases. Nineteen of 49 case(18.4%) showed different results on the W4D test with red/green glasses after reversal at near or distance, either changing fusional status or changing laterality of suppression. Four of 31 cases (18.0%) showed different status of fusion or suppression between W4D and Bagolini tests. We think that it repeating test twice, with the red/green glass reversed between trials, and with combination of Bagolini test, provides better reliability of W4D test.