PURPOSE: To investigate the effect of watching 3-dimensional (3D) television (TV) on refractive error in children. METHODS: Sixty healthy volunteers, aged 6 to 12 years, without any ocular abnormalities other than refractive error were recruited for this study. They watched 3D TV for 50 minutes at a viewing distance of 2.8 meters. The image disparity of the 3D contents was from -1 to 1 degree. Refractive errors were measured both before and immediately after watching TV and were rechecked after a 10-minute rest period. The refractive errors before and after watching TV were compared. The amount of refractive change was also compared between myopes and controls. The refractive error of the participants who showed a myopic shift immediately after watching TV were compared across each time point to assure that the myopic shift persisted after a 10-minute rest. RESULTS: The mean age of the participants was 9.23 ± 1.75 years. The baseline manifest refractive error was -1.70 ± 1.79 (-5.50 to +1.25) diopters. The refractive errors immediately after watching and after a 10-minute rest were -1.75 ± 1.85 and -1.69 ± 1.80 diopters, respectively, which were not different from the baseline values. Myopic participants (34 participants), whose spherical equivalent was worse than -0.75 diopters, also did not show any significant refractive change after watching 3D TV. A myopic shift was observed in 31 participants with a mean score of 0.29 ± 0.23 diopters, which resolved after a 10-minute rest. CONCLUSIONS: Watching properly made 3D content on a 3D TV for 50 minutes with a 10-minute intermission at more than 2.8 meters of viewing distance did not affect the refractive error of children.
Accommodation, Ocular/*physiology ; Child ; Depth Perception/*physiology ; Disease Progression ; Female ; Humans ; Imaging, Three-Dimensional/*adverse effects ; Male ; Refractive Errors/*physiopathology ; *Television ; Vision, Binocular/*physiology

PURPOSE: To discriminate the visual symptoms and signs of Meares-Irlen syndrome (MIS) and nonspecific dyslexia from other ophthalmologic diseases (NODs). METHODS: Forty-five patients were enrolled. Thirty four of the patients with MIS whose symptoms improved with tinted lenses comprised MIS group. The other 11 patients whose reading difficulty improved with other ocular therapy and did not require tinted lenses comprised NODs group. The main symptoms causing dyslexia and associated ocular diseases were evaluated. RESULTS: The mean age was 17.9 +/- 9.5 years in MIS group, and 19.3 +/- 11.0 years in NODs group. In MIS group, the most common symptoms while reading were difficulty to move lines (85%), doubling (53%), and difficulty in bright condition (27%). On the other hand, blurring was the most common symptom in NODs group (45%). The associated ocular diseases in the two groups were refractive error (79% and 73%), dry eye (29% and 18%), and exophoria (6% and 27%), respectively. CONCLUSIONS: Doubling, difficulty to move lines, and difficulty in bright condition while reading are main specific symptoms in MIS compared to nonspecific dyslexia from other ophthalmologic disorders.
Adolescent ; Adult ; Child ; Color ; Diagnosis, Differential ; Dyslexia/*diagnosis ; Eyeglasses ; Female ; Humans ; Male ; Night Vision ; Perceptual Disorders/*diagnosis/therapy ; Reading ; Refractive Errors/diagnosis/therapy ; Republic of Korea ; Retrospective Studies ; Syndrome ; Vision Disorders/*diagnosis/therapy ; Young Adult

PURPOSE: To evaluate the influence of suppression by intermittent exotropia on axial length progression. METHODS: The medical records of patients with intermittent exotropia who had undergone surgery at the Korea University Medical Center from 2003 to 2010 were reviewed. The age upon visit, age at operation, visual acuity, refractive error, type of strabismus, angle of strabismic deviation, suppression test (Vectographic projector test, Reneau, France), and axial length test were analyzed. Subjects with amblyopia or anisometropia were excluded. RESULTS: A total of 75 patients with intermittent exotropia who had definite suppression in 1 eye were identified. The mean age at visit was 6.87 +/- 2.73 years and mean angle of exodeviation was 25.65 +/- 6.68 / 26.17 +/- 6.59 (prism diopters, distant / near). There was no statistical difference in exotropia patients' interocular axial length value who showed suppression in 1 eye (p = 0.992 in the right-eye suppression group, and p = 0.528 in the left-eye suppression group). CONCLUSIONS: In the present study, there was no statistical difference in interocular axial length value of intermittent exotropia patients with suppression in one eye (p > 0.05).
Academic Medical Centers ; Amblyopia ; Anisometropia ; Exotropia ; Eye ; Humans ; Korea ; Medical Records ; Refractive Errors ; Strabismus ; Visual Acuity

PURPOSE: To evaluate the benefit of colored filters in Meares-Irlen Syndrome patients with reading difficulties. METHODS: Twenty-five patients were selected through a brief questionnaire aimed to determine symptoms of eyestrain or visual distortion after thorough eye examinations. The cutoff value of the questionnaire was 2.13. The rates of Korean reading and writing were measured using the RWSM (Reading Writing Speed Meter) test with and without the use of colored filters. Two months after wearing the individually prescribed colored filters, a questionnaire on the patient's subjective satisfaction with the colored filters were completed and evaluated. RESULTS: The blue (n = 8, 32%) and gray (n = 4, 16%) colors were the most frequently selected filters. The mean score of the questionnaire on reading difficulties was 2.72. The mean reading rate improved from 82.72 wpm (words per minute) to 101.84 wpm with the colored filters, a statistically significant change (p = 0.019). The mean writing rate did not improve. The overall satisfaction score with the colored lenses was 3.6, with the highest score given to ease of reading (4.08) and the lowest to writing (2.92). CONCLUSIONS: In cases of reading difficulty, colored filters were effective for alleviating visual symptoms and improving reading speed. It is important to achieve an adequate understanding of the specific symptoms of Meares-Irlen Syndrome and to perform a thorough eye examination to differentiate this from other ocular disorders.
Asthenopia ; Dyslexia ; Eye ; Humans ; Surveys and Questionnaires ; Writing

PURPOSE: To investigate preoperative concerns and expectations of caretakers and patients who underwent strabismus surgery and the patients course of return to daily life. METHODS: Eighty-five strabismus surgery patients were enrolled in this study. We performed a questionnaire survey including 11 questions about the concerns, expectations of strabismus surgery and the course of return to daily life after surgery. In total, 25 adult patients and 60 children with their caretakers were asked to fill out the questionnaire. RESULTS: The results showed that 77% of all patients and their caretakers expected that the strabismus would be cured after a single operation. The greatest concern before surgery was the possibility of strabismus recurrence (60%). Fifty five percent of the patients reported the use of an eye patch for 2 weeks to 1 month after surgery and 88% of them showed a 75-100% increase in performance after the operation. The most common reason for decreased performance was the use of an eye patch (61%). Most patients returned to normal daily activities within 1 to 2 weeks after surgery. CONCLUSIONS: Proper preoperative explanation about the possibility of recurrence may reduce concerns and false expectations about surgical outcomes. It appears to take 1 to 2 weeks for patients to return to their daily lives.
Adult ; Child ; Eye ; Humans ; Surveys and Questionnaires ; Recurrence ; Strabismus

PURPOSE: To suggest a surgical normogram for lateral rectus recession in exotropia associated with unilateral or bilateral superior oblique muscle palsy (SOP). METHODS: We retrospectively reviewed the charts of 71 patients with exotropia who were successfully corrected over one year. Each patient had undergone unilateral or bilateral rectus recession associated with uni- or bilateral inferior oblique (IO) 14 mm recession, using a modified surgical normogram for lateral rectus (LR) recession, which resulted in 1 to 2 mm of reduction of LR recession. We divided all patients into 2 groups, the 34 patients who had undergone LR recession with unilateral IO (UIO) recession group and the remaining 37 patients who had undergone LR recession with bilateral IO (BIO) recession group. Lateral incomitancy was defined when the exoangle was reduced by more than 20% compared to the primary gaze angle. The surgical effects (prism diopters [PD]/mm) of LR recession were compared between the two groups using the previous surgical normogram as a reference (Parks' normogram). RESULTS: The mean preoperative exodeviation was 20.4 PD in the UIO group and 26.4 PD in the BIO group. The recession amount of the lateral rectus muscle ranged from 4 to 8.5 mm in the UIO group and 5 to 9 mm in the BIO group. Lateral incomitancy was noted as 36.4% and 70.3% in both groups, respectively (p = 0.02). The effect of LR recession was 3.23 +/- 0.84 PD/mm in the UIO group and 2.98 +/- 0.62 PD/mm in the BIO group and there was no statistically significant difference between two the groups (p = 0.15). CONCLUSIONS: Reduction of the LR recession by about 1 to 2 mm was successful and safe to prevent overcorrection when using on IO weakening procedure, irrespective of the laterality of SOP.
Child ; Exotropia/complications/physiopathology/*surgery ; Eye Movements ; Female ; Follow-Up Studies ; Humans ; Male ; *Nomograms ; Oculomotor Muscles/physiopathology/*surgery ; Ophthalmologic Surgical Procedures/*methods ; Retrospective Studies ; Treatment Outcome ; Trochlear Nerve Diseases/*complications/physiopathology/surgery

PURPOSE: To analyze the postoperative strabismic angle for five years or more and to investigate when the angle stabilized in intermittent exotropia. METHODS: We retrospectively reviewed the clinical records of 89 patients who had undergone surgery for intermittent exotropia. The postoperative strabismic angles measured were analyzed at one-year intervals up to five years postoperatively. We divided them into two groups according to their age at the time of surgery. Group 1 was less than 5 years of age, while Group 2 participants were 5 years of age or older. RESULTS: For our 89 total patients, average exo-angles were 7.8 +/- 7.26, 7.9 +/- 7.51, 9.5 +/- 7.05, 10.1 +/- 6.87, and 9.4 +/- 6.90 prism diopters at one, two, three, four, and five years postoperatively, respectively. Average exo-angles between postoperative year one and year three, as well as between postoperative year two and year three, were statistically significant (p = 0.015, 0.022). However, the angles were not statistically significant between postoperative year three and year four or between years three and five, respectively (p = 0.707, p = 0.948). The stabilization characteristics of the angle were somewhat different according to age group. In Group 1, the average exo-angle in postoperative years one and three were statistically significant (p = 0.016), but the angle in the same period was not statistically significant in Group 2 (p = 0.203). CONCLUSIONS: There was no significant interval change after three years postoperatively in intermittent exotropia, but if the patient's age at surgery was 5 years or higher, no significant change of exo-angle was found following postoperative year one in this study.
Adolescent ; Child ; Child, Preschool ; Exotropia/physiopathology/*surgery ; Eye Movements/*physiology ; Female ; Follow-Up Studies ; Humans ; Male ; Oculomotor Muscles/physiopathology/*surgery ; Postoperative Period ; *Recovery of Function ; Retrospective Studies ; Treatment Outcome

PURPOSE: To investigate clinical characteristics of constant exotropia patients with a previous history of intermittent exotropia. METHODS: Constant exotropia patients (CXT) with a previous history of intermittency, and intermittent exotropia patients (X [T]) who had undergone surgery for exotropia were included in the present study. Patching therapy of the fixating eye was performed for all patients. Surgical results, the effect of patching, lateral incomitancy, and suppression were retrospectively reviewed and compared between the 2 groups. RESULTS: The number of CXT was 51 and X (T) was 84. The angles of deviation at the initial visit and at surgery were significantly larger in CXT. After 3 months of patching therapy, there was no difference between the 2 groups in the reduction of distant angle of deviation. However, the reduction of near angle of deviation was 0.29 +/- 5.44 in CXT and 4.42 +/- 6.26 Delta in X (T), which was significantly different (p = 0.04). Lateral incomitancy was observed in 7.8% of CXT and 34.5% of X (T) (p < 0.001). The angles of deviation at the final visit and surgical success rate were not different between the groups. Preoperative suppression at distant was found in 100% of CXT and 88.7% of X (T), and postoperative suppression was in 17.6% and 18.3%, respectively. CONCLUSIONS: The surgical success rate and postoperative suppression were not different between constant exotropia and intermittent exotropia. However, the frequency of lateral incomitancy and the response to the patching therapy was lower in constant exotropia.
Exotropia ; Eye ; Humans ; Retrospective Studies

PURPOSE: The purpose of this paper is to investigate how much correction is obtained per millimeter of medial rectus (MR) resection for recurrent exotropia after bilateral lateral rectus (BLR) recession, and to determine the difference in the effects between unilateral and bilateral resection, and the influence of previous lateral rectus (LR) recession on the effects of MR resection. METHODS: A total of 59 patients who had undergone MR resection after BLR recession were included in this study. The unilateral group consisted of 38 patients and bilateral group, 21 patients. Thirty patients in the unilateral group were divided into two groups: patients who had undergone previous LR recession of 7 mm or greater (21 patients) and less than 7 mm (9 patients). Main outcome measures were average deviation corrected per millimeter of MR resection at 1 month postoperative. RESULTS: The average effect of MR resection was 4.2 prism diopters (PD, 2.0 to 6.7 PD)/mm. The average effect in the unilateral group was 4.2 PD/mm and 4.1 PD/mm in the bilateral group. There was no significant difference between groups (P = 0.60). The average effect in the recession 7 mm or greater group was 4.0 PD/mm, and the average effect in the recession less than 7 mm group was 4.2 PD/mm (P = 0.698). CONCLUSIONS: The effect of MR resection per millimeter was variable. The laterality and previous amount of LR recession did not influence the effect of MR resection. These variable outcomes dictate that caution be exercised when MR resection is performed for recurrent exotropia.
Adolescent ; Adult ; Child ; Exotropia/physiopathology/*surgery ; Eye Movements/physiology ; Follow-Up Studies ; Humans ; Middle Aged ; Oculomotor Muscles/physiopathology/*surgery ; Ophthalmologic Surgical Procedures/*methods ; Recurrence ; Retrospective Studies ; Treatment Outcome ; Young Adult

PURPOSE: The purpose of this paper is to investigate how much correction is obtained per millimeter of medial rectus (MR) resection for recurrent exotropia after bilateral lateral rectus (BLR) recession, and to determine the difference in the effects between unilateral and bilateral resection, and the influence of previous lateral rectus (LR) recession on the effects of MR resection. METHODS: A total of 59 patients who had undergone MR resection after BLR recession were included in this study. The unilateral group consisted of 38 patients and bilateral group, 21 patients. Thirty patients in the unilateral group were divided into two groups: patients who had undergone previous LR recession of 7 mm or greater (21 patients) and less than 7 mm (9 patients). Main outcome measures were average deviation corrected per millimeter of MR resection at 1 month postoperative. RESULTS: The average effect of MR resection was 4.2 prism diopters (PD, 2.0 to 6.7 PD)/mm. The average effect in the unilateral group was 4.2 PD/mm and 4.1 PD/mm in the bilateral group. There was no significant difference between groups (P = 0.60). The average effect in the recession 7 mm or greater group was 4.0 PD/mm, and the average effect in the recession less than 7 mm group was 4.2 PD/mm (P = 0.698). CONCLUSIONS: The effect of MR resection per millimeter was variable. The laterality and previous amount of LR recession did not influence the effect of MR resection. These variable outcomes dictate that caution be exercised when MR resection is performed for recurrent exotropia.
Adolescent ; Adult ; Child ; Exotropia/physiopathology/*surgery ; Eye Movements/physiology ; Follow-Up Studies ; Humans ; Middle Aged ; Oculomotor Muscles/physiopathology/*surgery ; Ophthalmologic Surgical Procedures/*methods ; Recurrence ; Retrospective Studies ; Treatment Outcome ; Young Adult