By Carole Bowden, Simmons, Norris, Joanne Masters, Noble, Cunliffe, Richard R. Suminski, Jack J. Kanski, Anne Bolton, Ettinger, R. Muller, Roger, Devinksy
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Additional info for Binocular Vision & Orthoptics
It may he related to anomalies of accommodation, and a cycloplegic refraction is wise (see Chapter 1). Exercises may help (see Chapter 3), but it is rare as a primary condition and is usually caused by lateral rectus weakness. If so, it should be managed as an incomitant deviation (see Chapter 12). Summary Anomalies of convergence are functional rather than pathological. but they reduce visual efficiency and cause distressing symptoms. The common conditions of convergence insufficiency and convergence excess can be very effectively treated by an optometrist who modifies the prescription or organizes a brief period of exercises.
Butterworths. Mallett, R. F. J. (1966). Investigation of oculo-motor balance. Part 2. Ophthal. , June 25,654-7. North, R. V. and Henson, D. B. (1982). Effect of orthoptics upon the ability of patients to adapt to prism-induced heterophoria. Am. J. Optom. Physiol. , 59,983-6. Saladin, J. J. and Sheedy, J. E. (1978). A population study of relationships between fixation disparity, hetrophorias and vergences. Am. J. Optom. Physiol. , 55, 744-50. Sheedy, J. E. and Saladin, J. J. (1983). Validity of diagnostic criteria and case analysis in binocular vision disorders.
Other antisuppression exercises include uniocular reading with the suppressing eye or. for children. using a red filter over the non-suppressing eye and a red pen while colouring in letters or pictures. Improve the convergence. Give pencilto-nose exercises using an accommodative target. and ensure that diplopia is appreciated at the break point. If the patient has reasonable convergence, a better exercise is one employing physiological diplopia. Using a dot card from the tip of the nose. two lines of dots are seen, which will automatically cross at the point of fixation.