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Am J Ophthalmol. 2012 Dec;154(6):981-986.e3. doi: 10.1016/j.ajo.2012.05.026. Epub 2012 Sep 5.

Binocular visual acuity in intermittent exotropia: role of accommodative convergence.

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1
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Abstract

PURPOSE:

To investigate binocular interaction of visual acuity (VA) in patients with intermittent exotropia and its relationship with accommodative responses during binocular vision.

DESIGN:

Prospective pilot study.

METHODS:

setting: Institutional. patient: Sixty-three patients with intermittent exotropia between 8 and 15 years of age. observation: Binocular VA and monocular VA were measured in sequence. Accommodative responses of both eyes were measured using the WAM-5500 autorefractor/keratometer (GrandSeiko) during binocular and monocular viewing conditions at 6 m. Accommodative responses during binocular vision were calculated using the difference between the refractive errors of binocular and monocular vision. main outcome measures: Binocular interactions of VA were categorized as binocular summation, equivalency, or inhibition. The prevalence of the 3 patterns of binocular interaction was investigated. Accommodative responses were correlated with differences between binocular VA and better monocular VA.

RESULTS:

Most patients (38 patients; 60.3%) showed binocular equivalency. Binocular summation and inhibition were noted in 19 (30.2%) and 6 (9.5%) patients, respectively. Linear regression analysis revealed a significant correlation between binocular interaction and accommodative responses during binocular vision (P < .001). Accommodative responses significantly correlated with the size of exodeviation at distance (P = .010).

CONCLUSIONS:

In patients with intermittent exotropia, binocular interaction is associated with accommodative response during binocular vision and the size of exodeviation, suggesting that accommodative convergence is a mechanism that maintains ocular alignment. Therefore, binocular interaction, especially binocular inhibition, can be a good indicator of diminishing fusional control in intermittent exotropia.

PMID:
22959882
DOI:
10.1016/j.ajo.2012.05.026
[Indexed for MEDLINE]
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