Index

A refractive adaptation, 103–104 Abducens palsy, 71 , 97 Abnormal central nervous system (CNS) , 2 sensitivity, 100 Abnormal central nervous system (CNS) , 3 stereoacuity test, 101 Acquired motor neuropathy, 71–72 , 97 Acquired nonaccommodative esotropia, 2 treatment compliance, 105 Acquired pulley heterotopy, 63–64 type of treatment, 103 treatment 2009 vision in preschoolers study age eff ect, 131 (VIP), 100, 101 amblyopia management vision tests, 100 patch occlusion, 128–129 vs. diagnostic test, 97 pharmacological therapy, plano , 130 , 33 pharmacological treatment, atropine, 129–130 Anisometropic amblyopia, 2, 3 refractive correction, 127–128 Anomalous head posture (AHP) Bangerter fi lters, 132–133 Anderson–Kesternbaum surgery, 158 bilateral refractive amblyopia, 131 binocular visual acuity testing, 161–162 clinical features, 126 horizontal management, 165–166 deep unilateral amblyopia, 175–176 idiopathic infantile , 158 diagnosis, 126–127 measurement, 160–161 epidemiology, 125–126 monocular eff ect, 161–162 levodopa/carbidopa adjunctive therapy, 133 straightening eff ect, head, 162 long-term persistence, 132 testing, near vision, 162 maintenance therapy, 131 vertical management, 166–167 natural history data, 127 Anomalous retinal correspondence (ARC), 34 , 133–134 Atropine, 129–130 spectacle correction, 125 Amblyopia, screening B Child Health Promotion Program (CHPP), 96 Bagolini test, 141 classifi cation, 95 Bangerter foils, 132 conventional occlusion, 104 Bell’s phenomenon, 88 cover-uncover test, 100–101 Bielschowsky head tilt test (BHTT), 181 defi nition, 95–96 Bilateral feedback control Duane’s/Brown’s syndrome, 97 applications, 21–22 justifi cation, 98 muscle lengths, 19–21 lay screeners, 102 Bilateral posterior tenectomy, 190 older children, 104–105 Bilateral refractive amblyopia, 131 optical penalization, 104 Binocular alignment system orthoptists, 102 control system pharmacological occlusion, 104 A-/V-pattern strabismus, 14 photorefractive keratectomy (PRK), 105 basic muscle length, 15–16 photoscreening/autorefraction, 101–102 bilateral phenomena, 14–15 pre-school vision screening, 98–99 breakdown, 14 quality of life fi nal common pathway, 17–18 emotional well-being, 107 perturbation, 13 impact of treatment, 108 sensory torsion, 14 impact on education, 106–107 version and vergence stimulation, 16–17 reading speed and ability, 106 deviation and fi xation pattern, 11 strabismus impact, 107–108 long-term maintenance, 11 recurrence, 105 muscle length adaptation, 12–13 228 Index

vergence adaptation, 12 congenital trochlear palsy, 82 Duane retraction syndrome, 79–81 angle of strabismus, 140–141 HGPPS, 81 at age six, 140 isolated uni-/bilateral facial palsy, 83 bilateral recession vs. unilateral recession-resection, 141 vertical retraction syndrome, 88 Blood–brain barrier, 133 Congenital esotropia, 2 Botulinum toxin A (BTXA), 197, 203, 204 Congenital exotropia, 3 Brown syndrome, 4, 203 Congenital fi brosis of the (CFEOM), Brückner test 78–79 amblyopia and amblyogenic disorders, 113–114 A-pattern exotropia, 69 corneal light refl ex, 114–115 motor axonal misrouting, 67 eye movements, alternating illumination, 122 MRI, 67–68 fundus red refl ex phenotypes, 67 ametropia, 116, 118 Congenital nystagmus anisometropia, 118 clinical characteristics, 156–157 esotropia, 117–118 compensatory mechanisms foveal dimming, 117 AHP, 160–162 hypermetropia, 118 versions and vergence, 160 Mittendorf’s spot, 115 manifest latent nystagmus (MLN) optic coherence tomography, 117 clinical characteristics, 157–158 paediatric residents, 119 slow phase, 157 possibilities and limitations, 120 periodic alternating nystagmus (PAN), 158–159 pupillary constriction, 116 sensory defi cits test performance, 119–120 afferent visual defect, 155 transillumination test, 115 causes, 156 uncorrected ametropia, 118 horizontal eye movement, 154 uni-lateral astigmatismus, 119 idiopathy, 155 uni-lateral spherical ametropia, 118, 119 phenotypical characteristics, 155 pupillary light refl ex treatment eccentric vs. central illumination, 121 acupuncture, 164 pathology, 120 artifi cial divergence surgery, 167–168 monocular illumination, 121 botulinum toxin-A (Botox), 164 possibilities and limitations, 121–122 head tilt, 167 strabismus diagnostics, 120 horizontal AHP, 165–167 test performance, 121 medications, 162–163 prisms, 163 C refractive correction, 162 , 2, 3 retro-equatorial recession, 168–169 Child Health Promotion Program (CHPP), 96 spectacles and contact lenses (CL), 162–163 Chronic progressive external ophthalmoplegia (CPEO), surgical principles, 164–165 59–60 tenotomy procedure, 169 CNS-associated , 4 vertical AHP, 166–167 Complete third nerve palsy hypertropia, 198–199 Congenital oculomotor (CN3) palsy, 67 Congenital cranial dysinnervation disorders (CCDDs), 66 Congenital pulley heterotopy, 62–63 brainstem and cranial nerve development, 77, 78 Congenital superior oblique paresis, 20, 21 Brown syndrome Congenital trochlear (CN4) palsy, 69 comorbidity, 85 Convergence insuffi ciency, 3 epidemiologic features, 85 Cycloplegic drug, 127 incidence and heredity, 86 Cyclovertical misalignment, 19 intra-and postoperative fi ndings, 87 laterality, 85–86 D motility fi ndings, 83–85 Diagnostic occlusion, 19 natural course, 87 Dissociated eye movements neurodevelopmental disorder, 89–90 pathogenetic role, 29 potential induction, 86–87 vergence eye movements, 25 radiologic fi ndings, 87 dissociated horizontal deviation (DHD), 25–29, 179–180 saccadic eye movements, 85 dissociated torsional deviation (DTD) sex distribution, 86 inverse and direct head tilt, 181 CFEOM, 78–79 strabismus, 180 congenital , 82 dissociated vertical deviation (DVD) congenital monocular elevation defi ciency, 87–89 asymmetric vs. symmetric surgeries, 178 congenital , 81 bilateral, 175–176 Index 229

hypotropia, nonfi xating eye, 178–179 G IOOA and V pattern, 176–177 German Institute for Quality and Effi ciency in Healthcare SOOA and A pattern, 177–178 (IQWIG), 99 symmetric, 175 Glucocorticoids (GC), 213 Divergence paralysis esotropia, 64–65 Graves orbitopathy Double elevator palsy, 83, 87, 88 active infl ammatory phase Duane’s retraction syndrome (DRS), 69, 79–81 combined therapy, 213 Duane’s syndrome, 19 dysthyroid optic neuropathy (DON), 214 Dysthyroid optic neuropathy (DON), 214 glucocorticoids (GC), 213 immunosuppressive treatments, 213–214 E orbital radiotherapy (OR), 213 EOM surgery, 216–217 sight-threatening corneal breakdown, 214 Esotropia (ET) symptoms, 214–215 DHD, 179–180 childhood, 222 monofi xation syndrome, 35–36 classifi cation, 211–212 visual cortex mechanisms clinical assessment binocular input correlation, 50–51 activity signs, 208–209 binocular visuomotor behavior assess severity, 209–211 development, 42, 43 orbital imaging, 211 cerebral damage risk factors, 41–42 clinical characteristics, 208 cortical binocular connections, 44–46 diabetes, 222 cytotoxic insult, cerebral fi bers, 42 environmental and genetic infl uence early-onset (infantile) esotropia, 41 cigarette smoking, 221 extrastriate cortex, striate cortex, 46 susceptibility genes, 221–222 fusional vergence and innate euthyroid, 222 convergence bias, 44 Graves disease (GD), 207–208 genetic infl uence, cerebral connection, 42 inactive disease stages high-grade fusion repair, 50 extraocular muscle surgery, 216–217 inter-ocular , 46–47 lid surgery, 217–220 monocular compartments, striate cortex, 44, 46 orbital decompression, 215–216 motion sensitivity and conjugate eye tracking, 44 management plan, 208, 210 naso-temporal inequalities, cortical suppression, 47 thyroid dysfunction, 220 persistent nasalward visuomotor bias, 47–50 sensorial fusion and stereopsis development, 43 H strabismic human infant repair, 50 Health-related quality of life (HRQoL), 98, 99, 106–108 Essential . See Congenital esotropia Horizontal gaze palsy with progressive scoliosis Exotropia (XT) (HGPPS), 81 DHD, 179–180 Hypertropia, 3–4, 179 infantile esotropia active divergence mechanism, 26 I binocular fusion vs. dissociated esotonus, 27, 28 Immune myopathy, 60–61 clinical signs, 27 Incomplete third nerve palsy hypertropia, 199 horizontal strabismus, 28 Infantile esotropia (IE) Expected value of perfect information (EVPI), 99 defi nition and prevalence, 137 Extraocular muscle (EOM), 196, 197 dissociated eye movements Eye lid surgery pathogenetic role, 29 lower lid lengthening, 218, 219 vergence eye movements, 25 upper and lower lid blepharoplasty, 218 early vs. late infantile strabismus upper lid lengthening, 217 surgery study (ELISSS) alignment and fusion, 145 F binocular vision, 140 First Purkinje images, 114–115 horizontal angle of strabismus, 140–141 Fourth nerve palsy hypertropia methods and results, 139–140 bilateral involvement, 201 postoperative angle of strabismus, 145 congenital superior oblique palsy, 200 prospective study, 139 inferior oblique weakening procedure, 203 random-effects model, 146, 148 superior and inferior rectus recession, 209 reoperation rate, 142–143 superior oblique strengthening procedure, 209 spontaneous reduction, 146–148 superior oblique tendon laxity, 201 spontaneous resolution, 146 superior rectus contracture, 201 test-retest reliability, 144–145 surgical plan, 200 esotonus vs. convergence, 28 torsional , 202–203 exotropia 230 Index

active divergence mechanism, 26 N binocular fusion vs. dissociated esotonus, 27, 28 Neoplastic myositis, 61 clinical signs, 27 Neuroanatomical strabismus horizontal strabismus, 28 acquired motor neuropathy, 71–72 outcome parameters, 138–139 acquired pulley heterotopy, 63–64 pathogenesis, 138 congenital peripheral neuropathy sensory/motor etiology, 137–138 congenital cranial dysinnervation disorders tonus, 25–26 (CCDDs), 66 Infantile-onset image decorrelation, 38–39 congenital fi brosis of the extraocular muscles Inferior oblique (IO) palsy, 71–72 (CFEOM), 67–69 Inferior oblique overaction (IOOA), 4, 176–177 congenital oculomotor (CN3) palsy, 67 Infl ammatory myositis, 61 congenital trochlear (CN4) palsy, 69 Intermittent exotropia, 3, 4 Duane’s retraction syndrome (DRS), 69 Moebius syndrome, 70 L congenital pulley heterotopy, 62–63 Levodopa, 133 divergence paralysis esotropia, 64–65 Logistic regression analysis, 143 etiology, 59 Long-term binocular alignment control system, 14 extraocular myopathy immune myopathy, 60–61 M infl ammatory myositis, 61 Manifest latent nystagmus (MLN) neoplastic myositis, 61 Anderson–Kesternbaum surgery, 158 primary EOM myopathy, 59–60 clinical characteristics, 157–158 traumatic myopathy, 61–62 idiopathic infantile nystagmus, 158 vergence and gaze abnormalities, 72 slow phase, 157 Normal correspondence (NRC), 34 Marcus-Gunn phenomenon, 80–82, 85, 87–89 Marlow occlusion, 19 O Meta-regression model, 143 Ocular albinism (OA), 155 Microstrabismus Ocular motility disorders, CCDD number of operations brainstem and cranial nerve development, 77, 78 postoperative angle of strabismus, 145 Brown syndrome reoperation rate, 142–143 comorbidity, 85 test-retest reliability, 144–145 epidemiologic features, 85 random-eff ects model, 146, 148 incidence and heredity, 86 spontaneous reduction, 146–148 intra-and postoperative fi ndings, 87 spontaneous resolution, 146 laterality, 85–86 Mittendorf’s spot, 115 motility fi ndings, 83–85 Möbius syndrome, 83 natural course, 87 Moebius syndrome, 70 neurodevelopmental disorder, 89–90 Monofi xation syndrome (MFS) potential induction, 86–87 animal models, 37 radiologic fi ndings, 87 anisometropia, 33 saccadic eye movements, 85 bi-fi xation, 36–37 sex distribution, 86 causes, 33 CFEOM, 78–79 foveal suppression elimination, 36 congenital fourth nerve palsy, 82 manifest strabismus, 35–36 congenital monocular elevation defi ciency, 87–89 micro-esotropia congenital ptosis, 81 extrastriate cortex, 52–53 congenital trochlear palsy, 82 neural mechanism, 51 Duane retraction syndrome, 79–81 neuroanatomic fi ndings, 52, 53 HGPPS, 81 stereoscopic threshold, 52 isolated uni-/bilateral facial palsy, 83 subnormal stereopsis and motor fusion, 51 vertical retraction syndrome, 88 normal and anomalous binocular vision Ocular motor control system, 18 anomalous retinal correspondence (ARC), 34 Oculocutaneous albinism (OCA), 155 binocular correspondence, 34–35 Oculomotor palsy, 71 communication, 33 Optic neuropathy, 133–134 cortical adaptation, 34 Optical coherence tomography (OCT), 155, 156 ocular dominance column, 33, 34 Orbital radiotherapy (OR), 213 normal/near-normal fusional vergence, 37 primary MFS, 38–39 P Motor skills, 106 Paralytic strabismus Muscle length adaptation, 11–13 complete third nerve palsy, 198–199 Index 231

fourth nerve palsy hypertropia measurement technique, 188 bilateral involvement, 201 superior rectus muscle recession effects, 186–188 congenital superior oblique palsy, 200 suspension technique, 188–189 inferior oblique weakening procedure, 203 tendon incarceration syndrome, 185 superior and inferior rectus recession, 209 frenulum, 185 superior oblique strengthening procedure, 209 theoretical eff ect superior oblique tendon laxity, 201 anterior–posterior axis, 189 superior rectus contracture, 201 posterior tenectomy, 190 surgical plan, 200 SO anatomy, 190, 191 torsional diplopia, 202–203 SO tendon, 189, 192 incomplete third nerve palsy, 199 threefold function, 189 principles two-dimensional trigonometry, 192 preoperative assessment, 196–197 surgery timing, 195–196 T surgical treatment, 197–198 Th yroid-stimulating hormone receptor (TSHR), 208 hypertropia Traumatic myopathy, 61–62 lateral and medial rectus resection, 204 Trochlear palsy, 71 medial rectus weakening, sound eye, 204–205 TSHR antibodies (TRAb), 208 Pediatric strabismus Two-dimensional trigonometry, 192 adult strabismus, 7 associated conditions, 4 U esodeviation, 1–2 Unilateral strabismus changes exodeviation, 3 cyclovertical deviation, 20, 21 hyperdeviation, 3–4 head-tilt changes, 21 surgery rates, 4 ipsilateral medial and contralateral rectus muscle, 19 worldwide incidence and prevalence, 4–7 torsional position, 20 Periodic alternating nystagmus (PAN), 158–159 vertical recordings, 21 Pharmacological occlusion, 104 Photorefractive keratectomy (PRK), 105 V Plano lens, 130 Vergence adaptation, 11, 12 Posner’s maneuver, 174 Vertical retraction syndrome, 88 Posterior partial tenectomy, 190 Visual cortex mechanisms Primary extraocular muscle (EOM) myopathy, 59–60 esotropia Primary oblique muscle overaction, 14 binocular input correlation, 50–51 Prism adaptation, 12 binocular visuomotor behavior development, 42, 43 cerebral damage risk factors, 41–42 Q cortical binocular connections, 44–46 Quality adjusted life years (QALY), 99 cytotoxic insult, cerebral fi bers, 42 early-onset (infantile) esotropia, 41 R extrastriate cortex, striate cortex, 46 Reversed fi xation test (RFT), 179 fusional vergence and innate convergence bias, 44 genetic infl uence, cerebral connection, 42 S high-grade fusion repair, 50 Sensory esotropia, 2, 3 inter-ocular suppression, 46–47 Sensory exotropia, 3 monocular compartments, striate cortex, 44, 46 Sixth nerve palsy hypertropia motion sensitivity and conjugate eye tracking, 44 lateral and medial rectus resection, 204 naso-temporal inequalities, cortical suppression, 47 medial rectus weakening, sound eye, 204–205 persistent nasalward visuomotor bias, 47–50 Stereoacuity skills, 106 sensorial fusion and stereopsis development, 43 Superior oblique overaction (SOOA), 176–177 strabismic human infant repair, 50 Superior oblique (SO) surgery micro-esotropia clinical investigation extrastriate cortex, 52–53 6–0 Polyglactin 910 sutures, 186 neural mechanism, 51 asymmetric effects, 189 neuroanatomic fi ndings, 52, 53 enucleation, 186 stereoscopic threshold, 52 Jampolsky’s recommendations, 187 subnormal stereopsis and motor fusion, 51