scholarly journals Symptomatic classic convergence insufficiency treated with dot card orthoptic exercise

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Charles Darko-Takyi ◽  
Kofi Asiedu
Keyword(s):  
Developing Countries ◽  
Binocular Vision ◽  
Refractive Error ◽  
Female Student ◽  
Convergence Insufficiency ◽  
Vision Assessment ◽  
African Patients ◽  
Vision Therapy

Although lots of studies have been reported on convergence insufficiency (CI), no specific case of CI among African patients has been reported. We report a case of symptomatic <em>classic</em> convergence insufficiency in a female student who previously had been misdiagnosed and managed for refractive error. This case highlights the need for comprehensive binocular vision assessment, administration of validated symptom questionnaires in cases of suspicious CI, and the use of simple and inexpensive vision therapy procedures to manage CI in optometric centres in developing countries.

scholarly journals Symptomatic vergence disorders in junior high school children in Ghana

2016 ◽  
Vol 75 (1) ◽  
Author(s):  
Charles Darko-Takyi ◽  
Naimah E. Khan ◽  
Urvashni Nirghini
Keyword(s):  
High School ◽  
Binocular Vision ◽  
Junior High School ◽  
Junior High ◽  
Cape Coast ◽  
Cross Sectional ◽  
School Based ◽  
Convergence Insufficiency ◽  
Vision Assessment ◽  
Divergence Insufficiency

Background: Optometrists in Ghana are hampered in performing comprehensive binocular vision assessments, because of the lack of appropriate instruments leading to a paucity of data on vergence disorders and their association with asthenopia among Ghanaian school children.Aim: To establish the prevalence of symptomatic vergence disorders among junior high school (JHS) children in Cape Coast Metropolis, Ghana, in their habitual (vision) states and investigate if there were any associations between these disorders and specific asthenopic symptoms.Methods: A prospective cross-sectional school-based study using a multistage sample of 627 participants aged 12–17 years from JHSs in Cape Coast Metropolis. Participants completed a reliable asthenopic symptoms questionnaire and 220 participants who expressed two or more severe or very severe symptoms were selected for comprehensive binocular vision assessment in their habitual vision state.Results: The prevalence of symptomatic vergence disorders among JHS children in Cape Coast Metropolis was 14.8%. For specific symptomatic vergence disorders, the prevalence was: 1.4% basic esophoria, 1.4% basic exophoria, 8.6% convergence insufficiency, 1.8% convergence excess, 0.8% fusional vergence dysfunctions and 0.8% divergence excess. No participant had symptomatic divergence insufficiency. The study revealed significant associations between some specific symptomatic vergence disorders and specific asthenopic symptoms even though all of these asthenopic symptoms overlapped in other vergence disorders.Conclusion: Presenting complaints of specific asthenopic symptoms does not differentiate between specific types of vergence disorders. A comprehensive binocular vision assessment is vital in the diagnosis and management of these disorders to relieve asthenopia.

BYNOCS®1 – A Cloud-Based Indigenous Tele-Health Vision Therapy Software for the Assessment and Management of Binocular Vision Disorders

2020 ◽  
pp. 243-251
Keyword(s):  
Visual Acuity ◽  
Binocular Vision ◽  
Case Reports ◽  
Case Series ◽  
Strabismus Surgery ◽  
Care Practice ◽  
Digital Era ◽  
Vision Assessment ◽  
User Friendly ◽  
Vision Therapy

Background: Binocular vision assessment is an integral part of an eye and vision care practice. With the need for a user friendly, simplified, and comprehensive tool especially in this digital era, we propose a new indigenous cloudbased software, Bynocs.® This manuscript describes the technical details, the functioning of this indigenous software, and a case series demonstrating the application and efficacy of Bynocs® as a tele-health vision therapy tool. All the three cases were handled remotely through the Bynocs tele-health vision therapy platform. Case Reports: Case 1: This is a case of symptomatic convergence insufficiency who had prior compliance issues with a conventional vision therapy approach. With 10 sessions of Bynocs vision therapy focused on improving convergence amplitudes, the patient showed significant improvements in both subjective and objective parameters. Case 2: This case is of a 12 year old child with residual anisometropic amblyopia who had excellent compliance with patching therapy for 3 years but visual acuity had plateaued over the last 6 months. After 20 sessions of Dichoptic amblyopia therapy, best-corrected visual acuity (BCVA) improved by 3 log MAR lines, with improvements in stereoacuity to 100 sec of arc. Case 3: This case of a 10 year old child with residual exophoria after strabismus surgery was referred for managing the residual deviation and associated visual complaints. The child had 20/20 visual acuity in both eyes and 10 prism diopters of residual exophoria at distance and near. After 30 sessions of vision therapy, improvements in fusional vergence amplitudes was achieved along with the deviation restoring to orthophoria at both distance and near, with further improvements in stereoacuity from 400 sec of arc to 120 sec of arc. Conclusions: As tele-health is finding favor across the globe, Bynocs® can be a valuable tele-health vision therapy tool for in the management of binocular vision anomalies and amblyopia with the functionality for remote diagnosis and therapy.

Vision and Athletic Performance: Data from Agility Dogs

2018 ◽  
pp. 38-47
Keyword(s):  
Binocular Vision ◽  
Refractive Error ◽  
Athletic Performance ◽  
Individual Case ◽  
Spherical Equivalent ◽  
Physical Attributes ◽  
Eye Alignment ◽  
Vision Therapy ◽  
The Relationship ◽  
Cover Test

Background: To explore the relationship between vision problems and athletic performance, we measured refractive error and binocular vision in highly trained canine athletes. This group offers the opportunity to examine vision effects pristinely, without any influence of corrective lenses or vision therapy. Such a study is impossible in humans, but can add insight about the influence vision has on athletic performance in general. Methods: 210 dogs were recruited via word of mouth and examined at agility events in California, Texas, and Washington for cover test near and far, prism bar vergence near and far, Hirschberg and Bruckner tests for eye alignment, and retinoscopy. Owners and/or trainers categorized each dog as a good or poor jumper. Results: 190 dogs qualified; 54 (28.4%) had binocular disorders and 136 (71.6%) did not. Among those without binocular problems, mean SE was +0.07 D for good jumpers and -0.82 D for poor jumpers; poor jumpers were significantly more myopic and had more astigmatism than good jumpers. However, because the distribution of refractive errors in our sample was broad (from -3.00 to +3.00 spherical equivalent), some myopic dogs were good jumpers and some emmetropic and hyperopic dogs were poor jumpers. Binocular vision problems had a separate and sometimes additive effect, with anisometropia and unilateral (constant) strabismus more strongly related to poor jumping than alternating strabismus. Regression analysis showed that binocular competence had relatively more weight in jumping than refraction. Conclusions: Refractive error and binocular problems can affect jumping behavior in highly trained canine athletes. However, these vision problems are not predictive for any individual case, and as with human athletes, some individuals appear able to overcome physical attributes that for others are limiting. The results support the importance of vision, and in particular binocular and refractive problems, to athletic performance for humans as well as canines.

scholarly journals Vergence and Accommodative Dysfunctions in Emmetropic and Myopic Chinese Young Adults

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Martin Ming-Leung Ma ◽  
Anna Chwee Hong Yeo ◽  
Mitchell Scheiman ◽  
Xiang Chen
Keyword(s):  
Binocular Vision ◽  
Refractive Error ◽  
Linear Trend ◽  
Common Finding ◽  
Sample Population ◽  
Chi Square ◽  
Cross Sectional ◽  
Convergence Insufficiency ◽  
Chinese Young Adults ◽  
Divergence Insufficiency

Purpose. To investigate the association between refractive error and common binocular vision and accommodative dysfunctions in Chinese adults and to report the percentage of these disorders in this sample population. Methods. This was a single-site, prospective cross-sectional clinic-based study. A total of 415 Chinese participants aged between 21 and 38 years were grouped into 4 refractive error groups (emmetropia, low, moderate, and high myopia) based on the spherical equivalent power of noncycloplegic refraction. Baseline testing including binocular vision and accommodative testing was performed on all eligible participants. A multiple-sign classification system was used to analyze these data for the diagnosis of common nonstrabismic binocular vision and accommodative dysfunctions. Associations between the diagnosis and refractive error groupings were examined by the chi-square test for the linear trend. Results. Associations with refractive error groupings were found for convergence insufficiency (p=0.008, r = −0.13) and divergence insufficiency (p=0.008, r = 0.131). The 3 most common dysfunctions in this sample population were basic exophoria (10.8%), convergence insufficiency (9.6%), and divergence insufficiency (7.0%). Approximately 40% of the sample population demonstrated at least one type of binocular vision dysfunction. Conclusion. Convergence insufficiency and divergence insufficiency were associated with refractive error groupings. Binocular vision dysfunction was a common finding in this sample population.

Binocular Vision Anomalies and Normative Data (Band) In Tamilnadu – Study Design and Methods

2015 ◽  
pp. 260-270
Keyword(s):  
Study Design ◽  
Binocular Vision ◽  
Normative Data ◽  
Cross Sectional ◽  
Assessment Protocol ◽  
Rural And Urban ◽  
Vision Assessment ◽  
Prevalence Estimates ◽  
Design And Methods ◽  
Vision Therapy

Purpose: To report the study design and methods of the “Binocular Vision Anomalies and Normative Data” (BAND) study in school children in Tamilnadu. Methods: This is a cross-sectional study with an estimated sample size of 936 in rural and urban arms of Tamilnadu. A total of four schools with similar socio-economic factors have been selected in the rural and urban arm and children between 7 and 17 years of age are included based on simple random sampling. All children will undergo an initial screening protocol, followed by comprehensive binocular vision assessment. Children who are asymptomatic and who pass the comprehensive binocular vision assessment protocol will be included in the normative data study and children who fail the binocular vision assessment protocol will be included in the binocular vision prevalence study. Vision therapy will be provided to children with symptomatic BV anomalies and binocular vision assessment will be repeated after vision therapy. The primary objectives are to calculate prevalence estimates of binocular vision (BV) anomalies, and development of normative data. After the prevalence estimates are calculated, receiver operating characteristic (ROC) analyses will be performed for the binocular vision tests to find the tests that have the maximum sensitivity and specificity. After the ROC analyses, re-assessment of prevalence with the minimum test battery will be carried out. Conclusion: This study is expected to provide the prevalence data for binocular vision anomalies in rural and urban Tamilnadu and normative data for binocular vision testing.

scholarly journals Efficacy of vision therapy in impaired stereoscopic depth with intermittent exotropia (true divergence excess) with unilateral amblyopia: a case report

2020 ◽  
Vol 7 (2) ◽  
pp. 773
Author(s):  
Reena Gupta ◽  
Richa Jangra ◽  
Gaurav Dubey ◽  
Ramesh Hooda ◽  
Nirmal Parmar
Keyword(s):  
Binocular Vision ◽  
Neural Plasticity ◽  
Visual Pathway ◽  
Intermittent Exotropia ◽  
Occlusion Therapy ◽  
Vision Assessment ◽  
History Of ◽  
Accommodative Convergence ◽  
Rate Of Recovery ◽  
Vision Therapy

Divergence excess (DE) can be described clinically as exotropia at far greater than the near deviation by at least 10 prism dioptres (PD). We are reporting a rare case of 25-year-old female visited in the eye department for a routine eye check-up with a history of decreased vision in one eye. On examination, it was detected as a case of unilateral amblyopia with intermittent exotropia of true divergence excess with high accommodative-convergence over accommodation (AC/A) ratio. The patient was asymptomatic from exo-deviation due to the presence of binocular vision and good fusional reserve. The patient was started on active conventional vision therapy along with occlusion therapy. Post 16 weeks of constant therapy, a vision assessment with complete squint assessment along with binocular vision tests were performed. The result interprets to support the use of active conventional vision therapy as an integral part of the clinical treatment of amblyopia and intermittent exotropia. The rate of recovery of several monocular functions monitored during the vision therapy period provides the evidence of neural plasticity at multiple sites in the visual pathway in this adult amblyope. Therefore, if an ordered plan is being followed for the management of the patient of unilateral amblyopia and divergence excess, it can yield long-lasting improvement in visual acuity and binocular functions of any age.

scholarly journals Convergence Insufficiency - Perception Error: A Review Article

2020 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Binocular Vision ◽  
Reading Performance ◽  
Vision Disorders ◽  
Eye Care ◽  
Visual Discomfort ◽  
Convergence Insufficiency ◽  
Single Vision ◽  
Vision Assessment ◽  
Proper Diagnosis ◽  
Binocular Single Vision

Ocular asthenopia associated with headaches and visual discomfort are the major complaints, clients have these days. Intensive near and digital works have brought many non-strabismic binocular vision disorders (NSBVD) in the clients. Convergence insufficiency (CI) is one of the most prevalent NSBVD. CI is a binocular vision dysfunction, characterized by the patient’s inability to accurately converge, or sustain accurate convergence when focusing on near objects. Apart from visual symptoms, CI is known to have effects on a children’s academics and a person’s daily life. In addition to visual discomfort, children with CI report symptoms affecting reading performance, such as loss of pace, loss of concentration, reading slowly, and trouble remembering what was read. Proper diagnosis of convergence insufficiency is simple, but it has been complicated by the unavailability of essential orthoptic tools; the attitude of practitioner and their knowledge adds to the hurdle. Why don’t we introduce term “CI Suspect” like “Glaucoma-Suspect” so that every individual if matches one or more criteria for CI diagnosis is subjected undergo a complete binocular single vision assessment? This will properly diagnose and manage the case and also make orthoptics as a proper sub-specialty for eye care practitioners.

Vision Therapy’s Role in Basic Intermittent Exotropia: A Case Report

2020 ◽  
pp. 64-73
Keyword(s):  
Treatment Option ◽  
Intermittent Exotropia ◽  
Effective Treatment Option ◽  
Control Scale ◽  
Case Presentation ◽  
Therapy Program ◽  
Convergence Insufficiency ◽  
Hispanic Male ◽  
Vision Therapy ◽  
Accommodative Function

Introduction: Vision therapy has been shown to be a successful treatment option for basic intermittent exotropia as long as a complete workup is performed to assess prognosis and appropriate management. Case Presentation: A 9 year old hispanic male presented to the clinic for a comprehensive exam and was subsequently diagnosed with a basic type intermittent exotropia with a V-pattern deviation. After thorough evaluation of binocular skills and accommodative function with a binocular vision evaluation, he was referred for a vision therapy program to improve fusional ranges, accommodative function, and symptoms. This program consisted of 20 sessions and significantly improved his binocular skills. Discussion: Basic intermittent exotropia can be treated in various ways. Vision Therapy is a worthwhile option. Surgical correction and overminus treatment have also been effective treatments. Assessment should include the intermittent exotropia control scale and the convergence insufficiency symptom survey. Vision therapy treatments focus on diplopia awareness, antisuppression, and fusional vergence ranges. Conclusion: Though more research is necessary, vision therapy has been proven to be a very effective treatment option in basic intermittent exotropia.

Successful Combination Therapy for Amblyopia Secondary to Micro-Esotropia And Anisometropia

2021 ◽  
pp. 195-200
Keyword(s):  
Visual Acuity ◽  
Combination Therapy ◽  
Refractive Error ◽  
Combination Treatment ◽  
Current Treatment ◽  
Short Term ◽  
Eccentric Fixation ◽  
Case Summary ◽  
Vision Therapy ◽  
Spectacle Correction

Background: Micro-esotropia is a small-angle esodeviation typically less than nine prism diopters. Patients with this ocular condition often develop amblyopia due to the presence of a constant unilateral strabismus and an anisometropic refractive error in the deviated eye. Current treatment methods for strabismic and refractive amblyopia include spectacle correction, patching, and vision therapy (VT). Case Summary: A 9-year-old Asian female presented with a constant left primary micro-esotropia with unsteady eccentric fixation, contributing to mild amblyopia and frequent suppression in the left eye. She also had a hyperopic anisometropic refractive error. Combination treatment of in-office VT with short-term patching therapy (two hours per day) was administered, with the goal of improving her binocularity, fixation, and visual acuity. Conclusions: Amblyopia results from binocular dysfunction, therefore monocular patching therapy alone will not improve the underlying issue. VT is necessary to actively treat binocularity and subsequently improve visual acuity, while short-term patching can be used in combination to effectively target monocular accommodation and fixation.

scholarly journals Effect of Binocular Vision Problems on Childhood Academic Performance and Teachers' Perspective

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Saif Hassan Alrasheed ◽  
Abd Elaziz Mohamed Elmadina
Keyword(s):  
Academic Performance ◽  
Binocular Vision ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Eye Care ◽  
Cross Sectional ◽  
Convergence Insufficiency ◽  
Teachers Perspectives ◽  
Academic Record

Purpose:  To see the effect of binocular vision problems on childhood academic performance and to record the teacher's perspectives about childhood eye care in Khartoum State of Sudan. Place and Duration of Study:  A descriptive cross-sectional study done among the school going children in the Khartoum State of Sudan during the year 2018. Study Design:  Descriptive cross sectional study. Material and Methods:  Three hundred and forty (340) primary school children’s were recruited for study by convenient sampling technique during the academic year 2018. After relevant history, ocular examination was performed. It included visual acuity measurement, assessment of refractive errors and binocular function tests. Academic performance of the children was recorded from academic records of the children. Finally, the qualitative data was derived from teachers’ perspectives about childhood eye care. Results:  Mean age of the participants was 11.96 ± 1.63 years. The findings revealed that (78.6%) of children achieved poor academic performances with decompensated exophoria at near. 52.7% children with poor academic performances had weak positive fusion reserve at near P = 0.04. 37.2% of the poor performers had convergence insufficiency. Fort eight percent of females with ocular complaints achieved poor academic performances P = 0.034. With regard to teacher's perspectives about childhood eye care, 98.8%believed that the vision problems had effect on the academic record of the children. Seventy percent of the teachers reported that the students did not undergo eye examinations before joining school. Conclusion:  Convergence Insufficiency and weak positive fusional reserve at near has a significant effect on academic performances.

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