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Background: Current research in the realm of teleoptometric examinations is largely focused on the refractive and ocular health components of the exam. The purpose of this study was to evaluate the validity of binocular vision and accommodative testing in a tele-optometric examination compared to an in-person examination. Methods: Thirty students, ≥18 years old, at the Illinois College of Optometry were recruited to participate in this study. A teleoptometric examination was completed using the DigitalOptometrics platform, followed by a standard in-person examination. The following tests were performed in both examinations: near horizontal heterophoria by von Graefe, near negative and positive fusional vergences (NFV and PFV, respectively) by Risley prism, and accommodative testing with fused cross-cylinder (FCC). Results: The mean near horizontal heterophoria by von Graefe was 2.09Δ ± 6.73∆ exophoria in the tele-optometric examinations and 2.07Δ ± 6.54∆ exophoria in the in-person examinations, with no statistically significant difference between the two examinations (p=0.98). The mean NFV break and recovery in the tele-optometric examination were 10.85∆ ± 3.17∆ and 7.08∆ ± 3.03∆, respectively, and 23.40∆ ± 7.71∆ and 15.38∆ ±7.31∆, respectively, in the in-person examination, with a statistically significant difference (for both, p<0.0001). The mean PFV break and recovery in the tele-optometric examination were 13.50Δ ± 4.24Δ and 9.36Δ ± 4.68Δ, respectively, and 25.86Δ ± 10.48Δ and 16.54Δ ± 7.18Δ, respectively, in the inperson examination, with a statistically significant difference (break: p=0.001, recovery: p=0.004). Agreement of NFV and PFV between the two examinations was poor. The average FCC in the tele-optometric versus in-person examination was +0.67 D ± 0.51 D and +0.96 D ± 0.33 D, respectively, with a statistically significant difference between the two examinations (p=0.012). Conclusions: The tele-optometric and inperson examinations had fair agreement on near heterophoria but poor agreement on break and recovery values of NFV and PFV. Accommodative testing with FCC was not equivalent between the two exams. [ABSTRACT FROM AUTHOR]

Background: There are many approaches to treating amblyopia; opaque patching is one of the most common. However, opaque patching is known to have limited patient compliance due to poor cosmesis and social stigma. Partial occlusion with translucent Bangerter foils is a viable alternative to opaque patching. Case Report: JR, a 12-year-old Caucasian male with refractive amblyopia, was referred for a vision therapy evaluation. In addition to reduced acuity of 20/50- OS, JR exhibited decreased accommodative and oculomotor skills. JR was fitted with a 0.3 Bangerter foil OD over his glasses to be worn 2-3 hours per day. JR was enrolled in weekly vision therapy and reevaluated after 10 and 20 sessions. After his 20-week progress check, JR's acuity improved to 20/30 OS. JR also reported a subjective improvement in reading ability and a decrease in frequency of headaches. Conclusion: Bangerter foils are an acceptable alternative to opaque patching for amblyopia treatment. When combined with active vision therapy, patients can see an increase in visual acuity, accommodative skills, and oculomotor control. [ABSTRACT FROM AUTHOR]

Strabismus is a common problem encountered by eye and vision care professionals and alternating exotropia is a common diagnosis of patients with strabismus. When measuring the deviation it is often easier to elicit consistent near fixation than at distance, particularly with children and special populations. The purpose of this study was to investigate the existence of a correlation between far gaze measurements with 10° or 25° of upward gaze at near with alternating exotropia. The sample was a cross-sectional pilot study of 41 patients with a definite diagnosis of basic alternating exotropia, either intermittent or constant. The deviation was first measured at far gaze and then in an up gaze position with neck flexion of 10° and 25°, respectively. The outcome measures were correlations between exotropia measurements in far gaze and both the 10° and 25° upward near gaze measures. Measuring exotropia in upward gaze instead of far gaze offers the possibility of a more reliable method of measurement with children and noncooperative patients. [ABSTRACT FROM AUTHOR]