Disruption of binocular vision following cataract surgery

Abstract

Abstract Purpose: The aim of this study was to assess the incidence of disruption of binocular vision following cataract surgery and to re‐evaluate the role of Orthoptists in pre‐assessment clinics for cataract surgery. Methods: A retrospective study was carried out of all patients who attended the hospital for cataract surgery between January 2003 and December 2003. The incidence of ocular motility disorders and diplopia which had been recorded in the case notes was noted pre‐operatively, two weeks post operatively and if it was still persisting more than six weeks post operatively. All patients with persistent diplopia/symptoms related to disruption of binocular vision had been referred for Orthoptic assessment. Results: In the period from January‐December 2003 2147 patients had cataract surgery, 93% of whom had surgery under local anaesthesia. There was a total of 17 (0.8%) cases with persistent disruption of binocular vision post cataract surgery. The aetiology of the binocular problems was divided into three groups 1)refractive, 2)pre‐existing deviation and 3)induced deviation. Treatment was by means of prisms, refractive correction, occlusion, Botulinum toxin and surgery. Conclusions: The incidence of disruption of binocular vision in those patients undergoing cataract surgery is not high. However the symptoms that they have can be very difficult for the Orthoptist to eliminate despite a range of treatment modalities. The Orthoptist therefore has an important role in pre‐assessment cataract surgery clinics in highlighting those patients in which there are potential binocular complications.