Neurophysiology of Binocular Single Vision and Stereopsis

Author(s):  
Peter O. Bishop
Author(s):  
Rebecca Ford ◽  
Moneesh Patel

The chapter begins by discussing the anatomy and actions of the extraocular muscles and central control of ocular motility, before covering the key clinical skills, namely patient assessment, assessment of ocular movements, visual acuity testing, tests of stereopsis and binocular single vision, tests of retinal correspondence and suppression, and Hess charts. It then covers the key areas of clinical knowledge, including amblyopia, binocular vision and stereopsis, concomitant strabismus, incomitant strabismus, restrictive ocular motility disorders, complex ocular motility syndromes, vertical deviations , and alphabet patterns, and the key practical skills, namely the principles of strabismus surgery and other procedures in strabismus. The chapter concludes with five case-based discussions, on myopic anisometropia, esotropia, infantile esotropia, orbital floor fracture, and consecutive exotropia.


2014 ◽  
Vol 170 (5) ◽  
pp. 785-789 ◽  
Author(s):  
Hinke Marijke Jellema ◽  
Elly Merckel-Timmer ◽  
Roel Kloos ◽  
Peerooz Saeed ◽  
Maarten P Mourits

ObjectiveTo evaluate the influence of strabismus surgery on quality of life (QoL) in Graves' orbitopathy (GO) patients.DesignProspective study of case series.MethodsConsecutive GO-patients who were scheduled for their first strabismus surgery were included in the study. The patients completed the GO-QoL questionnaire within 3 months before the surgery and 2–4 months after the surgery. A complete orthoptic examination, including the field of binocular single vision (BSV), was performed. Clinically relevant response (CRR) in the QoL was also evaluated.ResultsIn this study, 28 patients were included. The GO-QoL score for visual functioning was 46.3±24.2 before surgery and 65.7±30.5 after surgery (P=0.009). The GO-QoL score for appearance changed from 60.6±25.9 to 69.5±24.2 (P=0.005). After surgery, the field of BSV increased from 24.3±34.8 to 68.5±36.0 points (P=0.000). A weak correlation was found between the field of BSV and the visual functioning score after surgery (r=0.417; P=0.034). CRR was found in 20 (71%) patients. Those with a CRR showed a larger field of BSV (P=0.002) and better GO-QoL scores (P=0.008).ConclusionsGO-QoL score increases significantly for both visual functioning and appearance after the first strabismus surgery in GO-patients, showing the highest improvement for the visual functioning questions. Both the GO-QoL and field of BSV outcomes correlate well with the CRR.


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