Patients with convergence insufficiency were complaint from diplopia and asthenopia at near Most patients respond well to orthoptic therapy, glasses, prism. In the case of patient unresponsive to conventional non-surgical orthoptic treatment, surgery remained controversial due to recurrence of symptoms reported following conventional bilateral medial rectus resection. To overcome these problems, an angled tuck of the medial recti was performed. Strengthening of the lower margin of the medial recti, by tucking them more than these of the upper margin results in a same aligment of the eye for near and distance deviation and relief of symptoms.
Asthenopia ; Diplopia ; Eyeglasses ; Glass ; Humans ; Ocular Motility Disorders* ; Orthoptics ; Recurrence

To verify the changes of mesopic and photopic contrast sensitivity function of sound eye whose visual acuity was kept the same after occlusion therapy in the amblyopic children. Fourteen sound eyes of amblyopic children (mean; 7.67 years; S.D., 1.50 years) who kept their visual acuity the same after the occlusion therapy were tested. The children had 6 hours of part-time patch therapy for 3 months prior to this examination. Among 14 amblyopic children, 8 were anisometric and 6 were strabismic amblyopes. Using the visual capacity analyzer which measures the minimal contrast level at from low to high spatial frequencies, the contrast sensitivity of sound eye was measured, under both photopic and mesopic condition, before and after 3 months of occlusion therapy. Comparing the contrast sensitivity of sound eye after the occlusion therapy to that before the occlusion, there was no statistical difference in photopic condition. When it comes to mesopic condition, the contrast sensitivity decreased at the intermediate spatial frequency level (3-13 c.p.d, p=0.028) after the occlusion therapy. The occlusion caused statistically significant decrease in mesopic contrast sensitivity, when the visual acuity was not changed after the occlusion therapy. It may indicate that mesopic contrast sensitivity can be considered as a useful tool for early detection of hidden occlusion amblyopia.
Amblyopia/*physiopathology/*therapy ; Child ; *Contrast Sensitivity ; Humans ; Orthoptics ; Visual Acuity

PURPOSE: To evaluate the clinical manifestation and prognosis of convergence insufficiency after craniofacial trauma. METHODS: Twelve patients injured by craniofacial trauma were analyzed for the cause of trauma, ocular and accompanied non-ocular symptoms, presence of loss of consciousness, presence of craniofacial fracture and intracranial hemorrhage, treatment modality for ocular symptoms, change in strabismic angle and near point of convergence (NPC) after treatment and prognosis using clinical records from April 2008 to December 2014. RESULTS: Traffic accidents (8 patients) were the leading cause of trauma. Near diplopia (11 patients) was the leading type of ocular symptom and other following symptoms included headache, asthenopia and reading difficulty. Ten patients experienced loss of consciousness and craniofacial fracture and intracranial hemorrhage were observed in 7 patients. Intracranial hemorrhage and craniofacial fracture occurred in 3 patients and only 1 patient had neither intracranial hemorrhage nor craniofacial fracture. All 12 patients performed orthoptic exercises, but no improvement of near strabismic angle, NPC and ocular symptoms was observed. However, 4 patients who received surgery demonstrated improvement in near strabismic angle, NPC and ocular symptoms. CONCLUSIONS: Convergence insufficiency after craniofacial trauma occurred by relatively strong traumatic force and had a poor outcome in non-surgical methods such as orthoptic exercise. Surgery was an effective treatment method rather than orthoptic exercise.
Accidents, Traffic ; Asthenopia ; Diplopia ; Exercise ; Headache ; Humans ; Intracranial Hemorrhages ; Ocular Motility Disorders* ; Orthoptics ; Prognosis* ; Unconsciousness

Human ; Aged ; Middle Aged ; OPHTHALMOLOGY ; EYE DISEASES ; OPHTHALMOLOGIC SURGICAL PROCEDURE ; ORTHOPTICS ; VISION, OCULAR