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Authors
Wang, Dong Hyun; Chang, Jee Ho

Relationship between Cornea and Lid Margin Position on the Appearance of Strabismus

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Abstract/Introduction

Purpose 

Previous strabismus appearance studies using images from real face photographs could not preclude the effect of other facial landmarks, such as position and contour of brow, nose, and facial outline, from pure effect of ocular deviation itself. With conceptualized drawings of eyes, we simulated strabismus deviation and collected the responses of observers.

 

Methods 

The experiments consisted of three sessions: (1) one-eye, (2) two-eye cornea, and (3) two-eyelid deviation simulations. On a monitor, eight different ocular deviations in increments of 6 prism diopters of horizontal or vertical deviations were simulated. Nine ophthalmology residents were asked to choose between esotropia and exotropia for horizontal simulations and hypotropia or hypertropia for vertical simulations. Psychometric function fitting was performed. Detection sensitivity, point of subjective equality, and 95% thresholds were calculated.


Conclusion/Results

Results 

Between cornea and lid deviation simulations, there was no difference in 95% thresholds, points of subjective equality, and sensitivity (all p values > 0.10), reflecting that the relative location of cornea and lid was the determinant factor in recognizing ocular deviation. The sensitivities of vertical deviation simulations were higher than that of horizontal in two-eye cornea and lid comparisons (p values < 0.04) but not in one-eye (p value = 0.37).

 

Conclusions 

Our results suggest that the appearance of strabismus depends not on the absolute ocular alignment but rather on the reciprocal relationship of cornea and lid margin. Vertical misalignment was more apparent than horizontal misalignment.


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Vision therapy is well worth the response, time and effort. Our Son had a hard time focusing and writing neatly. After vision therapy Seth could complete a task in half the time if previously took. His abilities to focus improved greatly and so did his handwriting.

Also, he was better at listening. As a parent, we wanted learning to be fun for our Son, and vision therapy made this possible.


Amanda T.

Vision Therapy is well worth the expense, time and effort. Our son had a hard time focusing handwriting neatly. After vision therapy Seth could complete a task in half the time it previously took his abilities to focus and improved greatly and so did his handwriting.

Also, he was better at listening. As a parent you wanted learning to be fun for our son and vision therapy made this possible.


Alexa H.

Vision Therapy has given or son the tools he needs to be able to scan and read the written word more effectively and efficiently.

He love working with John and these working sessions give him the motivation to gladly work on his homework assignments.

It amazed us to see the difference in the tracking of his eyes and along a line of it's from the beginning to the end of the treatment.

Dr. McBryar , Kristen and John  are all marvelous and we would recommend them to anyone I only wish that we would have found them sooner!


Charlotte M.

Prior to coming to the institute for vision development my son complained of daily headaches. Therapy has eliminated his headaches completely. I love knowing my son is able to learn pain-free for the rest of his life because of the work that has been done over just a few weeks in this office. He he absolutely loved coming that didn't even feel like going to a doctor or therapy. We are grateful for the relief he was able to find by coming here.

Thank you!


Olivia C.

Seems much less frustrated with life

Reads non-stop and fast

Spelling abilities have been hugely improved

Seems much more confident

Thank You!!!


Kelly O.

When we first came to the practice, my son did not have huge issues, but lots of small ones- trouble with reading, sports (hitting the baseball consistently), coordination, etc- that were not easily detectable,but when put together presented issues. The staff here were all very professional and loving towards him. While I was concerned in the reading, my son was concerned with the athletic side. Seeing improvement night off the bat gave him confidence that i have nor seen in him and made him want to not only Come to therapy, but also made him want to work hard. He has surpassed his grade level and above in reading and hit his first home run this year! Thank you!!!


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