No abstract available.
Humans ; Ocular Motility Disorders*

No abstract available.
Ocular Motility Disorders* ; Tuberculosis, Meningeal*

To investigate whether the slanted medial rectus recession can correct excess esotropia at near without overcorrection at distance and reduce the distance-near deviation difference, we examined 11 convergence excess esotropia patients who had deviation at near exceeding distance esotropia by 15PD or more, and underwent this operation. They composed of 7 partially accommodative esotropia with high AC/A ratio and 4 nonaccommdodative convergence excess esotropia. The surgical procedure consisted of bilateral, symmetrical slanted recession of the medial rectus muscle. The amount of recession of the upper and lower margins were calculated so as to correct the esotropia with correction at distance, and near respectively. The preoperative mean near and distance deviation were 33.8PD and 15PD, and each decreased to 9.2PD and 4.3PD postoperatively. The preoperative mean distance-near deviation difference were 18.8PD, and decreased to 5.4PD postoperatively. The 3 patients decreased over 10PD in the distancenear deviation difference. In conclusion, the surgical procedure, as bilateral slanted medial rectus recession, can correct excess esotropia at near without overcorrection at distance and reduce the distance-near deviation difference. Therefore, the bilateral slanted medial rectus recession may be used as the method of surgical treatment in convergence excess esotropia.
Esotropia* ; Humans ; Ocular Motility Disorders*

The authors report jerky seesaw nystagmus, extorsional downbeating in the ipsilesional eye and intorsional upbeating in the contralesional eye, in a patient with internuclear ophthalmoplegia (INO) from focal pontine lesion. This pattern of nystagmus may occur by disrupting pathways from contralateral posterior and anterior semicircular canals by a lesion in the medial longitudinal fasciculus. Depending on the pathways involved, various patterns of dissociated torsional-vertical nystagmus may accompany INO.
Humans ; Ocular Motility Disorders* ; Semicircular Canals

Internuclear ophthalmoplegia(INO)is a horiwntal ocular motor disturbance caused by a lesion of the medial longitudinal fasciculus. We have experienced a case of bilateral internuclear ophthalmoplegia associated with exotropia, which revealed the symptom of bilateral impairment of adduction and dissociated nystagmus of the abducting eye on horizontal gaze in either direction. No bilateral internuclear ophthalmoplegia caused by trauma has yet been reported in this country. Here we report the case of the trauma-related medial longitudinal fasciculus lesion and its pathophysiology along with a literatural review.
Exotropia ; Nystagmus, Pathologic ; Ocular Motility Disorders*

The authors report jerky seesaw nystagmus, extorsional downbeating in the right eye and intorsional upbeating in the left eye, in a patient with right internuclear ophthalmoplegia (INO). This pattern of nystagmus may occur by disrupting pathways from contralateral posterior and anterior semicircular canals by a lesion in the medial longitudinal fasciculus. Depending on damage to the pathways from contralateral vertical canals, various patterns of dissociated torsional-vertical nystagmus may accompany INO.
Humans ; Ocular Motility Disorders* ; Semicircular Canals

PURPOSE: To measure the ratio of accommodative-convergence to accommodation (AC/A ratio) in patients with pseudodivergence excess type and convergence insufficiency type of intermittent exotropia [X(T)], and to compare with a normal group. METHODS: A total of 55 subjects were divided into 3 groups: pseudodivergence excess type, convergence insufficiency type, and normal group. Age, gender, and refractive error of patients were examined. The deviation angle was measured at near and distance by using a prism cover test, followed by an interpupillary distance measurement. The AC/A ratio was calculated using a heterophoria and a gradient method. RESULTS: There was no statistically significant difference in age, gender, and the refractive errors among the 3 groups. The mean value of AC/A ratio using the heterophoria method was 9.50 in pseudodivergence excess type patients, 2.59 in convergence insufficiency type patients, and 5.47 in the normal group. Using the gradient method, the mean value of AC/A ratio was 1.47, 0.03, and 2.08 in each group, respectively. There was no statistically significant difference in mean values between patients with pseudodivergence excess type and the normal group, except when obtained using the gradient method (p = 0.43). CONCLUSIONS: A distinct difference in AC/A ratio existed when computed by the heterophoria method between patients with pseudodivergence excess type or convergence insufficiency type and the normal group. In the gradient method, however, the ratios of convergence insufficiency type patients were lower compared to the normal group, indicating the gradient method is more accurate than the heterophoria method.
Exotropia ; Humans ; Ocular Motility Disorders ; Refractive Errors

PURPOSE: To measure the ratio of accommodative-convergence to accommodation (AC/A ratio) in patients with pseudodivergence excess type and convergence insufficiency type of intermittent exotropia [X(T)], and to compare with a normal group. METHODS: A total of 55 subjects were divided into 3 groups: pseudodivergence excess type, convergence insufficiency type, and normal group. Age, gender, and refractive error of patients were examined. The deviation angle was measured at near and distance by using a prism cover test, followed by an interpupillary distance measurement. The AC/A ratio was calculated using a heterophoria and a gradient method. RESULTS: There was no statistically significant difference in age, gender, and the refractive errors among the 3 groups. The mean value of AC/A ratio using the heterophoria method was 9.50 in pseudodivergence excess type patients, 2.59 in convergence insufficiency type patients, and 5.47 in the normal group. Using the gradient method, the mean value of AC/A ratio was 1.47, 0.03, and 2.08 in each group, respectively. There was no statistically significant difference in mean values between patients with pseudodivergence excess type and the normal group, except when obtained using the gradient method (p = 0.43). CONCLUSIONS: A distinct difference in AC/A ratio existed when computed by the heterophoria method between patients with pseudodivergence excess type or convergence insufficiency type and the normal group. In the gradient method, however, the ratios of convergence insufficiency type patients were lower compared to the normal group, indicating the gradient method is more accurate than the heterophoria method.
Exotropia ; Humans ; Ocular Motility Disorders ; Refractive Errors

PURPOSE: To evaluate the preoperative ocular motility disorder and to study the relationship between motility disorder and morphologic change in blowout fracture. METHODS: The ocular motility disorders of 38 patients who had inferior wall orbital fracture were evaluated and classified using Hess test and quantified using field of biocular single vision (FBSV). The type and location of fracture and the morphologic changes of inferior rectus muscle was classified using computed tomography. RESULTS: In Hess test, up gaze disorder was found in 12 patients, down gaze disorder in 1, up and down gaze disorder in 21, and asymmetric disorder in 4. In up and down gaze disorder group, the FBSV score was significantly low (p<0.05) and the rate of entrapment or deviation of inferior rectus muscle was significantly high (p<0.05) in comparison with up gaze disorder group. CONCLUSIONS: The ocuar motility disorder induced by inferior wall orbital fracture could be evaluated using Hess test. The ocular motility disorder was more influenced by entrapment or deviation of inferior rectus muscle rather than the type or location of the fracture. Preoperative assessment of the ocular motility disorder could play an important role in evaluating the disorder of inferior rectus muscle and its treatment.
Humans ; Ocular Motility Disorders ; Orbital Fractures

PURPOSE: To evaluate the effects of converted intermittent exotropia type with part-time occlusion therapy on final postoperative outcomes. METHODS: The present study included 140 consecutive intermittent exotropia patients. On the patient's first visit, the type of intermittent exotropia was determined according to the deviation angle. After preoperative part-time occlusion therapy, the type of intermittent exotropia was reevaluated. The surgical success rates of each group was compared retrospectively according to the converted type. RESULTS: At the first visit, the basic type was the most prevalent (n = 112), followed by convergence insufficiency type (n = 18) and pseudo-divergence excess type (n = 10). Mean deviation angle on the first visit was 25.42 +/- 6.05 PD at distance and 26.19 +/- 8.20 PD at near. There were significant changes in near deviation angle after part-time occlusion in patients with the basic and convergence insufficiency types (p = 0.045, 0.03, respectively). Twenty-seven patients who had converted from basic type to pseudo-divergence excess type and from convergence insufficiency type to basic type showed better surgical success rate (89%) than other patients (69%) (p = 0.033). CONCLUSIONS: Part-time occlusion therapy converts the type of intermittent exotropia by reducing near deviation angle and is related to a better surgical success rate.
Exotropia ; Humans ; Ocular Motility Disorders ; Retrospective Studies