Comparison of stereoacuity in patients of anisometropia, isometropia and emmetropia

Purpose: To compare the stereoacuity in patients with anisometropia, isometropia, and emmetropia. Methods: A cross?sectional study was conducted on 1403 subjects (range: 5–45 years) divided into anisometropes (n = 403), isometropes (n = 500), and emmetropes (n = 500). There were 258 amblyopic eyes among anisometropes and 156 amblyopic eyes among isometropes. Stereoacuity was measured using the Titmus stereo test consisting of a combination of contour targets. Results: There were 675 males and 728 females. A significant (P < 0.001) reduction in stereoacuity was found in anisometropes as compared to isometropes and emmetropes. The stereoacuity was even worse in amblyopes as compared to non?amblyopes. Most patients with anisometropia of <3.0 D had fair stereoacuity. However, as the degree of anisometropia increased to >3.0 D, stereoacuity deteriorated gradually. Marked reduction of stereoacuity was observed in severe degree of anisometropia (>6.0 D). Overall, an anisometropia of ?2.12 D was associated with reduced stereoacuity. Among the anisometropes, it was found to be the poorest in myopia, followed by myopia with astigmatism, hypermetropia with astigmatism, and hypermetropia. Conclusion: The level of stereoacuity was worse in anisometropes as compared to isometropes and emmetropes. Amblyopes had a greater reduction in stereoacuity than non?amblyopes. Stereoacuity decreased as the degree of anisometropia increased. Among the anisometropes, myopes had worst stereoacuity than hypermetropes.

Study on stereoacuity and associated factors in school children aged 7 to 14 years

Purpose: The study aimed to estimate the prevalence of subnormal stereoacuity in school children and to assess the factors associated with it. Methods: In this prospective cross?sectional study, a total of 2,376 school children without amblyopia and manifest squint were screened by the titmus fly test, Snellen chart, tests for heterophoria, anterior segment examination, and fundoscopy. Children with a manifest squint, amblyopia (best?corrected visual acuity [BCVA] <6/18), and history of ocular trauma or surgery, and one?eyed children were excluded. Cycloplegic refraction was done in children with uncorrected or undercorrected refractive errors, and stereoacuity was assessed again with spectacle correction. Results: The prevalence of normal stereoacuity by titmus fly test was 93.18% with correction of refractive errors. Girls had slightly better stereopsis compared with boys. The subnormal stereoacuity was significantly associated with refractive error (P < 0.00001, significant at P < 0.05), unilateral refractive error (P < 0.00001, significant at P < 0.05), bilateral refractive error (P < 0.00001, significant at P < 0.05), anisometropia (P < 0.00001, significant at P < 0.05), ametropia (P < 0.00001, significant at P < 0.05), lower BCVA (P < 0.00001, significant at P < 0.05), hyperopia (P < 0.05, significant at P < 0.05), and heterophoria (P = 0.014, significant at P < 0.05). The subnormal stereoacuity was positively correlated with the magnitude of refractive error of the eyes. Conclusion: This study underlines the significant impact of identification and correction of refractive errors and squints in school children. The measurement of stereoacuity will be of immense importance and must be included in the screening programs for children

Application of fresnel prism in patients with different types of binocular diplopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To discuss the efficacy of fresnel prism in different types of binocular diplopia patients.<p>METHODS: This retrospective study reviewed 20 patients who received fresnel prism treatment between June 2018 and November 2020 in Jiangmen Central Hospital. Eight of them were diagnosed as acute acquired comitant esotropia, five patients were thyroid-associated ophthalmopathy, and seven patients were eye misalignment caused by cranial nerve palsies. The outcome measures were deviation, near stereoacuity, asthenopia and driving ability at pre-treatment and post-treatment.<p>RESULTS: The deviations were decreased after treatment. There were significant differences between pre-treatment and post-treatment(<i>P</i><0.05). The patients with acute acquired comitant esotropia or eye misalignment caused by cranial nerve palsies recovered near stereoacuity meanwhile significant difference between before and after treatment(<i>P</i><0.05). There were no significant differences between before and after treatment in patients with thyroid-associated ophthalmopathy(<i>P</i>>0.05). Thirteen patients recovered in the driving ability while fifteen patients were cured of asthenopia. There were significant differences between before and after treatment(all <i>P</i><0.05).<p>CONCLUSION: Fresnel prism treatment could decrease deviations in binocular diplopia patients, improved near stereoacuity and quality of life.

Evaluation of cerebral visual functions in low myopic adolescents / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore whether low myopia would affect cerebral visual functions by comparing perceptual eye position(PEP), fixation stability and stereoacuity tests between low myopic and normal adolescents. <p>METHODS: Totally 120 adolescents matched in age and gender participated in our study. Subjects were divided into three groups according to their refractive states. The cerebral visual functions tested in our study included perceptual eye position(PEP), fixation stability and stereoacuity. Stereoacuity tests involved in our study could be categorized into two parts. The first part was classical stereo tests including Titmus and synoptophore stereo test. The second part was 3D random-dot test for zero-order stereoacuity(hereinafter as zero-order test)at different viewing distances(0.8 m and 1.5 m).<p>RESULTS:1)PEP: the deviation of horizontal PEP was significantly larger in non-anisometropia when compared to control group. Both horizontal and vertical PEP bias pixels were significantly larger in anisometropia group. 2)χ2 test showed that both non-anisometropia group and anisometropia group had more trouble in holding their fixation stable. Moreover, anisometropia group had more abnormal results than other two groups. And in zero-order test at 1.5 m, both non-anisometropia and anisometropia had more abnormal results in stereoacuity than control group. The correlation between fixation stability and near stereoacuity(Titmus and zero-order stereoacuity at 0.8 m)was weak and positive.<p>CONCLUSION:Low myopic adolescents still have certain defects in cerebral visual functions; Examinations used in our study were useful in assessing cerebral visual functions. They could provide better follow-up evaluation and solid ground for further specific treatments in treating defects of cerebral visual functions. So far, local retinal environment has been the focus on the development in myopia. Our results suggested that researchers might pay more attention on visual cortex in studying the mechanisms of myopia in the near future.

A comparative study of stereoacuity in patients with various grades of cataract and bilateral pseudophakia

Purpose: To compare the stereopsis in patients with various grades of cataract and bilateral pseudophakia. Methods: A cross-sectional observational study was conducted at a tertiary care center in South India from December 2016 to September 2018, wherein the stereoacuity of patients having bilateral senile cataract or bilateral pseudophakia, was measured using the Titmus Fly chart. Those with any form of squint, glaucoma or retinal pathology were excluded. The patients were divided into three groups based on the severity of cataract, determined by the Lens Opacification Classification System (LOCS)-III. Group 4 included those with bilateral pseudophakia. Statistical analysis was performed using one-way ANOVA test with post hoc analysis using the Bonferroni test, to study the difference of stereoacuity between the groups. Results: A total of 200 patients were evaluated. The mean stereoacuity was 65.2 ± 18.2, 114.8 ± 83.42, 402.4 ± 223.7 and 107.2 ± 71.68 arc seconds in groups 1, 2, 3 and 4, respectively (P < 0.001). The mean best corrected visual acuity (BCVA) in LogMAR units was 0.19 ± 0.15, 0.37 ± 0.24, 0.82 ± 0.26 and 0.14 ± 0.13 in groups 1, 2, 3 and 4, respectively (P = 0.01). On comparison between four groups, there was a generalised decrease in BCVA and stereoacuity with increasing grades of cataract except for group 4 which included the bilateral pseudophakics. On post hoc analysis to analyse intergroup variation a statistically significant difference in stereo acuity was noticed when group 3 was compared to other groups. Conclusion: Stereoacuity decreases with increasing grades of cataract. Better stereoacuity is seen in patients with bilateral pseudophakia when compared with high grades of cataract.

Clinical study on distance and near stereoacuity changes in patients with different types of strabismus before and after surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To discuss and evaluate how different types of strabismus impact on the recovery of distance and near stereoacuity after strabismus surgery. METHODS:We selected 72 cases of strabismus who were treated in our hospital. They were divided into four groups: Group 1 as constant non - accommodative esotropia;Group 2 as intermittent exotropia; Group 3 as constant exotropia; Group 4 as exotropia V sign with inferior oblique hyperfunction. The distance stereoacuity were examined by synoptophore and the near stereoacuity was examined by Shaoming Yan's stereogram. Above examination data was collected and recorded before surgery,7d,1,3,and 6mo after surgery. RESULTS: The 72 patients' distance and near stereoacuity were significantly improved after their surgery, compared with their previous binocular vision. The improvement showed statistical significant(P<0.05). The recovery of Group 2's distance and near stereoacuity had been proved superior to that of Group 1, Group 3, and Group 4. The changes in the distance and near stereoacuity of Group 2 were statistically significant (P<0 05). There were no statistically significant changes in the distance and near stereoacuity of Group 1, Group 3, and Group 4 after the surgeries(P>0.05). The damage of distance stereoacuity (0 cases) was more severe than the damage of near stereoacuity (19 cases, 26%). After the surgeries, near stereoacuity's (51 cases, 71%) recovery was significantly superior to the distance stereoacuity's recovery(17 cases,24%). At 1mo after the surgeries,the improvement of distance and near stereoacuity was most obvious. CONCLUSION:Postoperative recovery of distance and near stereoacuity varies as per strabismus type. Intermittent exotropia's patients show the best recovery of distance and near stereoacuity after the surgeries. The clinical results on the recovery of distance and near stereoacuity after surgery for constant non -accommodative esotropia, constant exotropia and exotropia V sign with inferior oblique hyperfunction are consistent. As the distance stereoacuity of the patients with strabismus has more severe damage,the recovery of near stereoacuity is superior to that of distance stereoacuity.

Subnormal Binocular Contrast Sensitivity Summation in Patients with Intermittent Exotropia

BACKGROUND: To evaluate binocular summation ratio using contrast sensitivity (CS) testing and correlation between binocular summation and stereoacuity, and control scale in intermittent exotropia (IXT). METHODS: We conducted a prospective case-control study. Thirty-seven IXT and 41 controls were evaluated with both monocular and binocular CS testing. We compared the binocular summation ratio of IXT to that of controls. Near and distance stereoacuity was assessed and office-based control scale was evaluated. We investigated correlation between binocular CS summation ratio and stereoacuity, and control scale in IXT, respectively. RESULTS: IXT had lower binocular CS summation ratio than controls at 1.5 and 3.0 cycles/degree (1.01 ± 1.02 vs. 1.62 ± 1.88 and 1.17 ± 0.96 vs. 1.86 ± 1.75, Both P < 0.05). We found significant correlation between binocular CS summation ratio at 3.0 cycles/degree and both near and distance stereoacuity (r = −0.411, P = 0.012 and r = −0.624, P = 0.005), and ratio at 1.5 cycles/degree also correlated significantly with distance stereoacuity (r = −0.397, P = 0.034) in the IXT. Binocular CS summation ratio was correlated to control scale at 1.5 and 3.0 cycles/degree (r = −0.327, P = 0.041 and r = −0.418, P = 0.028), and the ratio significantly differed in control scale groupings analysis at the same frequencies (Both P < 0.05). CONCLUSION: Our findings of subnormal binocular CS summation ratio in IXT had correlation with stereoacuity and control scale suggest that binocular CS testing may be a useful method in assessing binocular visual function in IXT.

Effects of Monocular Blur on Clinical Measurements of Stereopsis and Binocular Contrast Sensitivity / Jurnal Sains Kesihatan Malaysia

Visual conditions such as anisometropia, monovision and monocular undercorrection affect the combination of visual input from both eyes. This study investigated the effects of monocular blur, in binocularly normal participants, on stereoacuity and binocular contrast sensitivity. Fifteen young adults (age range between 19 and 23 years old) with normal visual acuity and binocular vision participated in this study. Stereopsis was measured using the TNO test with a series of positive spherical lenses placed before the dominant eye. The procedure was repeated using the Titmus Stereotest on five participants as a control experiment. Monocular and binocular contrast sensitivities were also measured using the Pelli-Robson Contrast Sensitivity Chart. Blur was induced monocularly with a series of positive spherical lenses placed before the dominant eye and binocular contrast sensitivity was re-measured. Stereopsis scores decreased significantly when monocular blur was imposed. Across blur levels, absolute stereopsis scores measured with TNO test were worse than those measured with Titmus stereotest (all p < 0.05). However, the ratio of scores obtained without blur and under monocular blur appeared to be similar for both tests. Stereopsis without blur was between 6.82× to 8× better than that obtained with the highest level of imposed monocular blur. Binocular contrast sensitivity score decreased significantly with increasing level of monocular blur (p < 0.01). Binocular contrast sensitivity score without blur was 1.62× better than that obtained under binocular viewing with highest level of imposed blur. Stereopsis tests are more sensitive than measurements of binocular contrast sensitivity as an indicator of interocular acuity discrepancies which could occur in anisometropic or monovision patients. However, the choice of stereopsis test is crucial, as the TNO test appears to be more sensitive to monocular blur than the Titmus stereostest.

Relationship between Early Postoperative Stereoacuity and Surgical Outcome in Intermittent Exotropia

PURPOSE: To identify the correlation between early postoperative stereoacuity and surgical outcome in intermittent exotropia. METHODS: The medical records of 74 patients who underwent unilateral lateral rectus recession or bilateral lateral rectus recession for intermittent exotropia with a minimum postoperative follow-up of 3 years were retrospectively reviewed. Postoperative stereoacuity was measured using the vectogram test and Titmus test at 1 month post-operative. The deviation angle was measured at near and at distance using a prism cover test. Patients were divided into two groups according to post-operative angle deviation, and stereoacuity was analyzed in both groups. RESULTS: Sixty patients showed no suppression at distance at 1 month post-operative follow-up. Of these, 55 patients (85.9%) belonged to the success group and 5 patients (50.0%) belonged to the recurrence group. The post-operative suppression test and the surgical outcome exhibited a significant association (p = 0.017). 53 patients showed normal stereoacuity 1 month after surgery. Of these, 49 patients (76.6%) belonged to the success group and 4 patients (40.0%) belonged to the recurrence group (p = 0.017). Post-operative stereoacuity and surgical outcome exhibited a significant association (p = 0.026). CONCLUSIONS: Post-operative suppression test results at distance and stereoacuity at near may be helpful in predicting surgical outcomes of patients with intermittent exotropia.

Changes in stereoacuity following implantable Collamer lens implantation in patients with myopia.

The study evaluated the impact of implantable Collamer lens (ICL) implantation on stereoacuity in myopes in a retrospective case series. Ninety‑five eyes of 48 patients were recruited. Distance and near stereoacuity were measured using distance Randot stereotest and TNO test, respectively, before surgery and at 4 weeks postoperatively. Mean age of the patients was 23.67 ± 3.7 years. Mean uncorrected distance visual acuity (UDVA) was 1.28 ± 0.37 logarithm of the minimum angle of resolution (logMAR) (median: 1.3; range: 0.3–1.8), and median best‑corrected distance visual acuity (BDVA) was 0.18 logMAR (range: 0–0.6). There was a significant improvement in both UDVA and BDVA postsurgery (P < 0.001; Wilcoxon signed rank test). The overall improvement in stereopsis was observed in 15/48 (31.25%) and 13/48 (27.10%) subjects for near and distance, respectively, with no significant difference between the two (P = 0.82; Fisher’s exact test). Among stereoblind individuals, the odd’s ratio for near stereoacuity to improve in comparison to distance stereoacuity was 8.85 (95% confidence interval: 1.68–46.70; P = 0.01). ICL implantation for refractive correction aided stereoacuity improvement in myopes more so for near.

Long-Term Binocularity in Accommodative Esotropia

PURPOSE: To find clinical factors related to the long-term outcome of binocularity in accommodative esotropia. METHODS: Forty-nine patients with accommodative esotropia who were followed over 5 years after successful optical alignment within 8 prism diopters of orthophoria at near and distance with glasses including bifocals were included. The patients who had stereo acuity better than 50 seconds/arc and central fusion without suppression scotoma at the final visit were divided into the bifoveal fusion group and the others were divided into the peripheral fusion group. Clinical factors were analyzed between the two groups (Chi-square test, student t-test). RESULTS: Of the 49 patients, 15 patients were included in the bifoveal fusion group and 34 patients were included in peripheral fusion group. Mean follow-up was 88.9 +/- 25.4 months. Clinical factors that were significantly related to the bifoveal fusion group were older age of onset, shorter duration of misalignment, intermittent esotropia at the initial visit and after initial optical correction, smaller residual deviations at distance after initial optical correction and at the final visit, and lesser amblyopia. CONCLUSIONS: To obtain better levels of long-term binocularity, optical correction should be done as early as possible, before the presence of constant eye misalignment or amblyopia, and the residual esodeviations after optical correction should be kept as small as possible.

Relationship between Control Grade, Stereoacuity and Surgical Success in Basic Intermittent Exotropia

PURPOSE: This study was conducted to identify the relationship between control grade, stereoacuity and surgical success in basic intermittent exotropia. METHODS: This retrospective study involved 44 basic intermittent exotropia patients who underwent strabismus surgery and completed at least 6 months of follow-up. The 44 patients were divided into three subgroups according to their control grade: group 1 (good control group, n = 12), group 2 (fair control group, n = 18), and group 3 (poor control group, n = 14). Evaluation was done to identify the relationships between near and distance stereoacuity and control grade, and between surgical success and control grade. Surgical success was defined as ocular alignment between 5 prism diopters esodeviation and 10 prism diopters exodeviation in the primary position at the final visit. RESULTS: Mean near stereoacuity measured by the graded circle test was 57.50 seconds of arc (seconds) in group 1, 77.77 seconds in group 2, and 131.43 seconds in group 3 (p < 0.01). Mean distance steroacuity measured by Mentor B-VAT II BVS contour circle was 108.33 seconds in group 1, 148.33 seconds in group 2, and 262.82 seconds in group 3 (p < 0.01). Ten patients (83.33%) in group 1, 12 (66.67%) in group 2, and 9 (64.29%) in group 3 obtained surgical success (p = 0.28). CONCLUSIONS: In basic intermittent exotropia, better control grade was significantly accompanied by better stereoacuity. Better control grade was accompanied by higher surgical success rate but with no statistical significance.

Relationship between Control Grade, Stereoacuity and Surgical Success in Basic Intermittent Exotropia

PURPOSE: This study was conducted to identify the relationship between control grade, stereoacuity and surgical success in basic intermittent exotropia. METHODS: This retrospective study involved 44 basic intermittent exotropia patients who underwent strabismus surgery and completed at least 6 months of follow-up. The 44 patients were divided into three subgroups according to their control grade: group 1 (good control group, n = 12), group 2 (fair control group, n = 18), and group 3 (poor control group, n = 14). Evaluation was done to identify the relationships between near and distance stereoacuity and control grade, and between surgical success and control grade. Surgical success was defined as ocular alignment between 5 prism diopters esodeviation and 10 prism diopters exodeviation in the primary position at the final visit. RESULTS: Mean near stereoacuity measured by the graded circle test was 57.50 seconds of arc (seconds) in group 1, 77.77 seconds in group 2, and 131.43 seconds in group 3 (p < 0.01). Mean distance steroacuity measured by Mentor B-VAT II BVS contour circle was 108.33 seconds in group 1, 148.33 seconds in group 2, and 262.82 seconds in group 3 (p < 0.01). Ten patients (83.33%) in group 1, 12 (66.67%) in group 2, and 9 (64.29%) in group 3 obtained surgical success (p = 0.28). CONCLUSIONS: In basic intermittent exotropia, better control grade was significantly accompanied by better stereoacuity. Better control grade was accompanied by higher surgical success rate but with no statistical significance.

The Initial Factors Influencing Successful Final Stereoacuity in Refractive Accommodative Esotropia

PURPOSE: To evaluate the initial factors influencing successful final stereoacuity in patients with refractive accommodative esotropia. METHODS: The charts of 48 refractive accommodative esotropia patients 2 years of age or older andassessed using the Titmus stereoacuity test were retrospectively reviewed. Hyperopic refractive error on post-cycloplegic refraction, age at first glasses, stereoacuity after refractive correction and amblyopia were categorized and evaluated as the factors influencing final stereoacuity. RESULTS: The mean follow-up period was 43.51 +/- 30.02 months. The mean hypermetropia at the initial examination was 4.67 +/- 2.18 diopters (D), the mean age at first glasses was 48.09 +/- 20.22 months and the mean stereoacuity after refractive correction was 1243.75 +/- 1378.24 seconds of arc. The rates of successful stereoacuity at the final visit were 83.3% without amblyopia, 75.0% with mild amblyopia and 42.9% with moderate amblyopia which were statistically significant (p = 0.039). Hyperopic refractive error and age at first glasses were categorized as +1.0 to or =+5.0 D and 2 to or =6 years, respectively, and the rates of successful stereoacuity at the final visit were 83.3%, 66.7%, 61.9% (p = 0.362) and 71.4%, 75.0% and 54.5% (p = 0.334), respectively. CONCLUSIONS: The amblyopia at the initial examination was significantly associated with the outcome of stereoacuity at the final visit in patients with refractive accommodative esotropia.

Comparison of Outcomes According to Surgical Method in Partially Accommodative Esotropia in Patients Over 4 Years of Age

PURPOSE: To compare postoperative outcomes according to surgical method in partially accommodative esotropia in patients over 4 years of age. METHODS: We compared motor and sensory outcomes between conventional and augmented surgery in 66 patients. The postoperative follow-up period was at least 24 months. The formula for the amount of the rectus muscle recession was based on the distant angle deviation after hyperopic correction in the conventional group and the average amounts of the distant angle deviation with and without full correction of hyperopia in the augmented group. In addition, the conventional group was divided into 2 sub-groups to compare surgical outcomes. The A group consisted of patients who underwent surgery with the amount of surgical correction based on distant angle deviation after full hyperopic correction. The B group consisted of patients under the same condition after reduced hyperopic correction to achieve best corrected visual acuity (BCVA). RESULTS: Among the patients who had an ocular alignment less than 10 PD, orthophoria was significantly higher in the conventional group than in the augmented group on the last follow-up. When comparing the 2 conventional sub-groups, the postoperative stereoacuity was better in group B than in group A. Among patients with a postoperative overcorrected alignment of more than 10 PD who underwent augmented surgery, 75% showed decreased postoperative stereoacuity compared to preoperative stereoacuity. CONCLUSIONS: In partially accommodative esotropia in patients over 4 years of age, conventional surgery compared to augmented surgery after reduced hyperopic correction is better in order to achieve BCVA for postoperative stereoacuity as well as ocular alignment.

Distance Stereoacuity by Frisby Davis Distance Stereotest after Surgery in Intermittent Exotropic Patients

PURPOSE: To compare distance stereoacuity in patients with intermittent exotropia before and after surgery using the Frisby Davis distance stereotest (FD2), and to determine the preoperative factors that affect the postoperative distance stereoacuity. METHODS: A total of 56 patients with intermittent exotropia were examined for the present study. To determine preoperative factors that affect postoperative distance stereoacuity, age, gender, distance control, and presence of fusion were measured. The deviation angle was measured at near and at distance by using a prism cover test. Distance stereoacuity was measured with the FD2 test. RESULTS: According to the results of the FD2 test, the mean preoperative distance stereoacuity of patients was 64.7 +/- 76.1 sec of arc, and improved to 53.6 +/- 85.9 sec of arc postoperatively. The distance stereoacuity improved notably from 63.0 to 40.0 sec of arc after the successful surgery. No significant correlation was present between type of surgery, distance control, presence of fusion, and postoperative improvement of distance steroacuity. CONCLUSIONS: Decreased stereoacuity in intermittent exotropic patients improved postoperatively, and the FD2 test was valuable in evaluating the stereoacuity in intermittent exotropic patients pre- and postoperatively.

Clinical characteristics of congenital nystagmus / 中华实验眼科杂志

Background Congenital nystagmus is a common disease threatening visual function.The clinical description of congenital nystagmus is still not enough now. Objective The aim of this study was to report the motor and sensory characteristics of congenital nystagmus. Methods A retrospective clinical case analysis was designed.The clinical data of 376 patients with congenital nystagmus were collected.These patients were diagnosed in Henan Eye Institute from January,2005 to August,2011.The clinical characteristics of patients,including age,pedigree analysis,nystagmus classification,ocular alignment,visual acuity,refractive error,stereoacuity and oscillopia,was summarized.Informed consent from all patients and custodian were obtained. Results The age distribution of most patients was ＞5-10 years and ＞ 15-20 years,with the percentage 24.73％ and 24.20％,respectively.Of 376 patients,sensory defect nystagmus was 172 cases,and that of motor sensory defect was 204 cases.The most common inheritance pattern was autosomal dominant.Conjugate uniplanar horizontal oscillations were found in 73.94％patients,and strabismus was found in 66.36％ in this study.Sensory defected subjects did not show a statistically significantly higher strabismus incidence when compared with the idiopaths (x2 =3.048,P =0.081 ).The binocular distance vision in all the subjects was declined in comparison with normal eyes,the best corrected vision was 0.27 ±0.11 and 0.50± 0.13 in sensory defected nystagmus and idiopaths nystagmus respectively,showing a significant difference( t =16.495,P =0.000 ).The incidence of refractive error in this study was 77.62％.Incidence of astigmatism(75.17％ ) was higher than that of myopia and hyperopia ( 39.03％ and 36.12％ ).No significant difference was seen in refractive error incidence between the sensory defected and the idiopaths (x2 =1.337,P =0.248).Patients of 65.18％ displayed non-stereoacuity or very gross acuity levels (3000) in this study,and the patients with idiopathic nystagmus showed better stereoacuity level in comparison with sensory defected ones (x2 =7.058,P =0.008 ).Five of 313 patients existed experienced oscilopla under binocular viewing conditions.Conclusions Autosomal dominant inheritance is the most common pattern of congenital nystagmus.Conjugate uniplanar horizontal oscillation is thought to be a common type of nystagmus.Incidence of strabismus is higher,and visual acuity and stereoaeuity are worse in congenital nystagmus than in common population.Oscillopia is seldom found in congenital nystagmus.

Relationship between Control Grade and Stereoacuity in Basic Intermittent Exotropia

PURPOSE: The present study was conducted to identify the correlation between control grade and stereoacuity in basic intermittent exotropia (X[T]). METHODS: Eighty-six patients with basic X (T) were divided into 3 subgroups according to their control grade and the near and distant stereoacuities were evaluated. RESULTS: Group 1; good control group, consisted of 28 patients, group 2; fair control, 30 patients, and group 3; poor control, 28 patients. Mean near stereoacuities measured by the Titmus test were 58.21 arcseconds in group 1, 75.33 arcseconds in group 2, and 151.43 arcseconds in group 3. The mean distant stereoacuities measured by a Mentor B-VAT(R) II-SG videoacuity tester were 118.93 arcseconds in group 1, 165.33 arcseconds in group 2, and 276.43 arcseconds in group 3. When comparing the 3 groups, the poorer the control grade, the worse were the near and distant stereoacuities (p = 0.002, p < 0.001). When compared in pairs, however, group 1 showed a better near stereoacuity than groups 2 and 3 (p = 0.02, p = 0.002, respectively), while group 2 and group 3 did not show any distinct differences (p = 0.13). Group 1 also showed a better distant stereoacuity than groups 2 and 3 (p = 0.02, p < 0.001, respectively), as did group 2 compared to group 3 (p < 0.001). CONCLUSIONS: Control grade and distant stereoacuity have significant correlation in patients with basic X (T) and can function as helpful indicators for monitoring the deterioration and progression of exodeviation.

Clinical Manifestations and Surgical Outcomes of Intermittent Exotropia with or without Dissociated Vertical Deviation

PURPOSE: Clinical manifestations and surgical outcomes of intermittent exotropia with or without dissociated vertical deviation (DVD) were evaluated. METHODS: Patients who were diagnosed with intermittent exotropia following surgical correction were divided into 2 groups: 66 patients with DVD (DVD group) and 81 patients without DVD (XT group). The postoperative deviation between exodeviation of 10 prism diopters (PD) and esotropia of 5 PD was considered surgically successful. RESULTS: The onset of strabismus occurred at an earlier age in the DVD group. There were more cases of nystagmus, inferior oblique muscle overaction, superior oblique muscle overaction, and AV pattern in the DVD group than in the XT group, but there were no differences between the 2 groups in terms of head tilt, amblyopia, and age at first operation. While exodeviation in the DVD group was smaller than in the XT group, stereopsis in the DVD group was statistically worse than in the XT group in the Titmus test. At postoperative 1 month, the XT group had better surgical outcome, but at postoperative 6 and 12 months, there were no differences in the surgical outcomes of intermittent exotropia between the 2 groups. Regarding DVD surgery, a postoperative DVD angle less than 10 PD accounted for 90.0% of the cases. CONCLUSIONS: Intermittent exotropia combined with DVD had worse stereoacuity and lesser exodeviation. There was no statistically significant difference in the surgical outcomes of intermittent exotropia with or without DVD.

Strabismus and Poor Stereoacuity Associated with Kabuki Syndrome

Kabuki syndrome is characterized by long palpebral fissures, large ears, a depressed nasal tip, and skeletal anomalies associated with postnatal dwarfism and mental retardation. There have been few prior detailed descriptions of strabismus or stereopsis in these patients. We report a patient with Kabuki syndrome who showed small-angle strabismus and poor stereopsis. This case illustrates the need for patients with a diagnosis of Kabuki syndrome to have an ophthalmologic evaluation. Strabismus associated with Kabuki syndrome may have a small angle that can be easily overlooked.