Dissociated Horizontal Deviation in the Refractive Accommodative Esotropia with Amblyopia

ABSTRACT

Dissociated horizontal deviation(DHD) is a rare type of dissociative strabismus. It dose not obey the Hering`s law of equal innervation and is expressed in associated with dissociated vertical deviation or asymmetrical nystagmus blockage syndrome. We observed 6 cases of DHD among the patients with refractive accommodative esotropia associated with amblyopia. The mean age of the patients was 3.6 years and the average refractive error was +5.35D in the dominant eyes and +6.29D in the amblyopic eyes. The average visual acuity was 0.38 with the dominant eyes and 0.17 with the amblyopic eyes. The average angle of deviation was 40.0delta with fixation in the dominant eyes and 24.3delta in the amblyopic eyes. The authors speculate that this difference of angle deviation was caused by the weaker accommodative convergence at the time of fixation by the amblyopic eye that appeared to have decreased accommodative amplitudes.