Search

Purpose: This study assesses the effect of pleoptic treatment on the stability of visual fixation in children and adolescents with amblyopia of various degrees., Material and Methods: The effect of the treatment in 35 children (35 eyes) with amblyopia of various degrees was evaluated using the MP-1 Microperimeter. The stability was determined by two criteria - number of fixation point hits in the 2° zone and the width of the field of fixation. Children underwent a standard course of treatment., Results: There was an improvement in the stability of visual fixation after treatment. The number of fixation point hits in the 2° zone increased from 44.8±4.1% to 52.6±3.8%. At the same time, the width of the field of fixation after treatment decreased from 6.5±0.7° to 5.2±0.5°. Visual acuity with correction in children with amblyopia correlates with the number of fixation point hits in the 2° zone (direct high correlation "+0.7") and width of the field of fixation (inverse high correlation "-0.7") both before and after the treatment., Conclusion: Stabilization of visual fixation was observed in patients with amblyopia of varying degrees after the pleoptic treatment.

Most sources state that pleoptic treatment is ineffective after the age of 14 years. Despite the high level of diagnostic capabilities in modern ophthalmology, unilateral amblyopia is quite often diagnosed in adolescents. This rises the question - should they refuse treatment? To evaluate the impact of treatment on retinal light sensitivity and the state of the patient's visual fixation, a 23-year-old female patient with high degree amblyopia was examined using the MP-1 Microperimeter. Three courses of treatment were carried out to recover (centralize) fixation on the MP-1. In the course of pleoptic treatment, the patient was observed to have a gradual increase in the light sensitivity of the retina from 2.0 dB to 18.5 dB and centralization of visual fixation. Therefore, treatment in adult patients with high degree amblyopia is justified, since the method improves visual functions. The result will be less pronounced and persistent than in patients under the age of 14, but it is still possible to alleviate the patient's condition, which means that if the patient wishes to undergo treatment, it should be carried out.

This is a literature review on the use of diploptic treatment in concomitant strabismus.

Objective: to investigate the effectiveness of the method of "dissociation" for concomitant strabismus treatment, which involves laser speckles and polaroid separation of visual fields., Material and Methods: A total of 40 patients with different types of concomitant strabismus and the average age of 9.8 years were enrolled. The treatment method implies the use of the Forbis device with polaroid separation of visual fields and low-energy helium-neon laser speckle patterns (green and red, 0.53 pm and 0.65 pm correspondingly). Binocular vision recovery was performed in the conditions of alternating exertion and relaxation of accommodation obtained through plus and minus spherical lenses., Conclusions: The method ensures an increase in the number of individuals capable of stereopsis from 31.2-44.4% (conventional treatment) to 54.4% as well as widening of the range of tolerated plus/minus spherical lenses, in which the binocular fusion is retained at the same degree of convergence.

Character of vision in 105 children with strabismus (with regular eye position) was tested using four dot test on different distance (5.0, 2.5, 1.0 m) and "Phorbis" device comprising phoropter and a set of light filters, that let us perform examination in the conditions of colour, polaroid and bitmapped division of visual fields. Stereoscopic vision was examined using original method based on anaglyph haploscopy. Binocular vision in strabismus was found to become more frequent as the distance and dissociating effect of light-filters decrease, and turned to be maximal in near testing in conditions of bitmapped haploscopy. Visual stereoscopic acuity in children with concomitant strabismus even on reaching regular eye position and binocular vision is significantly lower compared with healthy children of the same age.

A modified procedure for diploid treatment is proposed to disinhibit a functional scotoma and to develop binocular vision (BV) in children with squint. The procedure is to examine a special test object through rotary prisms and polaroid filters inserted into a modernized spectacle frame. During treatment there is an opportunity of simultaneously changing the color of the test object and the position of its image on the retina. The study enrolled children in whom previous traditional methods for BV recovery had failed. Treatment using the proposed procedure could recover bifoveal fusion in 88.3% of cases (as evidenced by synoptophore examination) and BY in 73.3% (as shown by scanning haploscopy).

A method is proposed to study stereoscopic visual acuity (SVA) by means of the test objects designed by the computer program Adobe Photoshop CS 2 (version 9, 2005). Each test object contains 3-4 silhouette figures made on the principle of color anaglyphs with varying degrees of transverse disparity. The capacity of an examinee of correctly showing on the display screen the sequence of the layout for the figures in depth with a minimal disparity determines its SVA. The authors propose to consider a disparity of 30 seconds of angle as a unit of SVA. The results of SVA examination using the proposed method (when the same object is demonstrated) do not depend on the site of figures on the screen and on the distance between the examinee and the monitor.

The effect of steady-state nystagmus suppression has been found upon periodic light exposure of the eye. The paper describes the exposure facility and procedure based on the changes in the amplitude and frequency of light pulse until there is a response of a patient's nystagmus parameters that are continuously monitored by video-assisted computer system. After periodic light exposures, there was a persistent suppression of nystagmus and a steady-state increase in visual acuity by an average of 0.1.

The authors studied influence of new computer device--video helmet--on visual functions of children, adolescents and adults.

The paper discusses the problems of abnormalities of the oculomotor apparatus and binocular vision, considers the topical aspects of the pathogenesis and treatment of amblyopia, gives data on the new methods of recording the binocular movements of the eye, and provides evidence for the tactics and stage sequence of surgical treatment for concomitant oculomotor disturbances.

On the basis of examination of 172 patients with strabismus concomitant with ptosis, different clinical forms of the former were defined and their clinical variations were classified. Symptomatology was described for each form. An independent type of false positive ptosis was pointed out. The notion of "positive and negative fixation tests" was introduced. A proper interpretation of the origin of true and false ptosis was presented. Finally, a sequence and tactics of surgical and functional treatment of different clinical presentations of squint concomitant with ptosis are lain down.

The paper for the first time presents statistically processed data on the cyclofusion reserves of subjects with normal binocular vision (25) for different age groups: adolescents aged 12-14 and adults aged 18-35 years. Two types of tests for evaluating cyclofusion under conditions of haploscopy (sinoptophore) are offered. The results can be used as a criterion for evaluating cyclofusion in various oculomotor abnormalities: squint, diplopia, and cyclotropia.

A new method for diploptic treatment of strabismus is proposed, based on phase division of visual fields using liquid crystal eyeglasses --computer complex. The method is based on stereovision training (allowing stereothreshold measurements up to 150 ang. sec.). The method was tried in examinations of two groups of children: 10 controls and 74 patients with strabismus. Examinations of normal controls gave new criteria for measuring fusion reserves and stereovisual acuity by the proposed method. The therapeutic method was tried in 2 groups of patients. Time course of visual function improvement was followed up by several criteria: changes in binocular status by the color test and improvement of in-depth and stereoscopic visual acuity. The method is recommended for practice. The authors discuss the problem of small angle strabismus.

A new method of color division of the visual fields based on polarized light interference is described. A new method for diploptic therapy of strabismus is developed, based on the above principle and possessing numerous advantages. The method was used in 38 patients with binocular disorders of various severity; binocular function improved in 18. The method is particularly effective in the patients with correct position of the eyes with bifoveal fusion on the synaptophore and parallel color test vision and in the patients with binocular vision and amblyobinopia.

A method for treating amblyopia by using dynamic color objects (stimuli) influencing simultaneously different channels of the optic system is proposed. Original equipment based on polarized light interference was used, as well as a nomogram permitting rapid assessment of the optimal size of the offered test objects. The method was used in 90 children (99 amblyopic eyes). It reliably improved the efficacy of comprehensive treatment of amblyopia of different degree and origin and may be effectively used as the only method, particularly advisable for cases poorly treated by the traditional methods. The method is simple and interesting for young children.

A new method for treating amblyopia is proposed, making use of the phenomenon of polarized light interference. It helps act simultaneously on the brightness, contrast frequency, and color sensitivity in response to patterns. The method was used in the treatment of 36 children. In group 1 (n = 20) it was combined with the traditional methods. Such treatment was more effective than in controls treated routinely. Group 2 consisted of 16 children in whom previous therapy was of no avail. Visual function was improved in 7 of them.

The accommodation potential of the eye is markedly reduced in patients with optic nystagmus. Trans-scleral exposure of the ciliary body to infrared low-energy laser at wavelength 1.3 microns may be used to repair the accommodation potential of the eyes and improve the visual function in nystagmus. Laser stimulation of the ciliary zone was carried out in 62 patients with optic nystagmus. As a result, the accommodation potential was 1.417 times increased and the closest point of clear vision approached the eye by 1.309 diopters. Far vision acuity increased by 1.334 times, close one by 1.258 times. A stable positive result persisted for 3 to 6 months, after which laser stimulation may be repeated, or other means of repairing the accommodation system of the eye be resorted to, such as training after Avetisov-Mats or exercises with a home ergographer.

Clinical features of vertical strabismus with superior oblique muscle insufficiency were studied in 123 patients. A complex of clinical methods was used and clinical evaluation of these methods made. Various forms of strabismus with superior oblique muscle insufficiency were detected. Four degrees of superior oblique muscle weakness were distinguished corresponding to four degrees of inferior oblique muscle hyperfunction.

A method for therapy of strabismus and amblyopia with the use of IBM PC AT type computer is suggested. It consists in active interaction of a patient with various test objects on the monitor and is realized via a special set of programs. Clinical indications for the use of a new method are defined. Its use yielded good results in 82 of 97 children.

The authors describe a method for binocular vision studies with the use of spatial visual effects emerging when double images are fused in physiologic diplopia. Various forms of binocular cooperation were detected and a clinical classification of these forms developed, based on the ability to obtain a binocular visual image. One of the distinctions of the suggested method is the detection of not only binocular fusion, but of the ability to in-depth perception. The authors analyze the status of binocular function in subjects with various forms of binocular sensor cooperation, basing on binary metric data and the findings of the color test and synaptophore studies. Binocular cooperation impairments, detected by binary-metry, appear less severe than if detected by the color test or synaptophore studies in the same patients.

Examination of 328 patients with vertical squint has revealed peculiarities of its clinical forms. Their characteristics are: I. Concomitant vertical squint; II. A mixed form--concomitant convergent or divergent squint with a vertical component; III. Paretic or paralytic vertical squint; IV. Atypical kinds of vertical squint. Special attention is drawn to the presence of torticollis, difference in lid slit width, pseudoptosis, diplopia. Basic principles of treatment of vertical squint corresponding the clinical form are suggested. Results of treatment in patients with different forms of vertical squint are analysed.

The paper analyses results after treatment of patients with vertical squint (53 persons) using a principally new method--binarimetry, as one of diploptic methods. All patients had residual vertical deviation after surgical treatment or a small angle (to 10 degrees). The device and the method of treatment are described. In the most of patients, binocular vision was restored (77.3%) on account of development of vertical fusional reserves and correction of residual deviation.