Field Of Binocular Single Vision Research Articles

A Functional Scoring Method for the Field of Binocular Single Vision

The authors present a new method for plotting and quantitating the field of binocular single vision (BSV). They modified a Goldmann perimeter to project a fusion target in the form of a cross (+). Unlike previous methods that used a spot, which is a poor fusion target that cannot detect cyclotorsion, the authors' method permits a single tester to plot BSV fields in patients who have any combination of horizontal, vertical, and cyclotorsional diplopia. The BSV fields were plotted in 23 patients with acquired diplopia using both the fusion target and the spot. Scoring was performed using a new scoring template weighted to the functionally important areas around primary and reading positions. Nine patients (39%) had scores for the two targets that differed by more than 10%. The authors' method yields BSV scores that are reproducible and easy to perform and that can be used for preoperative and postoperative assessments, serial monitoring of changes over time, and disability evaluations.

Extraocular muscle surgery in myasthenia gravis.

Myasthenia gravis is typically a disease of young people in active employment who need a field of binocular single vision. Although it is systemically controllable with a good chance of spontaneous remission, persistent loss of binocularity may cause chronic disability. We report our experience of extraocular muscle surgery in five patients with stable myasthenia gravis and persistent double vision. Extraocular muscle involvement was selective, giving rise to incomitant and concomitant squints, with individual muscle overactions as well as underactions. Treatment was by conventional recession and resection procedures with the additional use of Faden and adjustable sutures where appropriate. In all five cases a larger, stable field of binocular single vision was established. It is concluded that extraocular muscle surgery may be beneficial in selected cases of myasthenia gravis.

Extraocular muscle surgery for Graves' ophthalmopathy: does prior treatment influence surgical outcome?

We analysed the results of extraocular muscle surgery in 38 patients with stable Graves' ophthalmopathy. Fixed sutures were used in all patients. A useful field of binocular single vision was achieved in 27 patients (71%) after one operation and in seven patients (18%) after more than one, whereas double vision was persistent in four (11%). No recurrence of diplopia was seen during one year of follow-up. No differences were found in duration of eye disease, angle of deviation, or in prior forms of treatment between patients who responded well to a single operation and those who needed more surgical procedures or those who responded less well. We conclude that, although the individual outcome cannot be predicted, every patient with diplopia and stable Graves' ophthalmopathy has an 89% chance of binocular single vision after extraocular muscle surgery. Prior treatment does not appear to influence this outcome.

Functional Scoring of the Field of Binocular Single Vision

Fifty-one patients with diplopia were investigated prospectively to assess the correlation between their subjective impression of disability from diplopia and an objective measurement obtained using a method of assessing the field of binocular single vision (BSV). The objective score generally exceeded the patient's own assessment and the scoring method has been modified to improve the correlation.

Functional Scoring of the Field of Binocular Single Vision in Patients with Diplopia

A simple method for scoring the field of binocular single vision (BSV) is presented. The field is plotted on the Goldmann Perimeter using the III-4e target. The method gives greater weight to functionally important areas, especially the primary and reading positions. Several cases illustrate the application of the proposed scoring system by correlating patients' subjective disabilities with their diplopia scores. The method is more precise than any previous scheme and provides a quantitative measure that makes the examination of patients with diplopia more accessible to legal evaluation and numerical analysis.

The investigation and management of torsion preventing fusion in bilateral superior oblique palsies.

Fifteen patients with bilateral superior oblique palsy were studied with respect to the influence of torsion on fusion with amplitudes. The Clement Clarke synoptophore was used to record torsion and examine fusion. Nine patients needed the correction of torsion preoperatively to fuse in the primary position. Three patients had central fusion disruption. Torsion in excess of 10 degrees or bilateral excyclotorsion were present in most patients who required torsion correction for fusion with amplitudes. All patients had surgery. The effects, at least three months after surgery, are discussed. Some residual excyclotorsion remained in most cases and appears to be compatible with a good fusional result and an average field of single binocular vision of 30 degrees.

Squint surgery in patients with Graves' ophthalmopathy.

The results of extraocular muscle surgery in 22 patients with Graves' ophthalmopathy were evaluated. All patients were classified in NOSPECS class 4. The mean age at the time of squint surgery was 55(10)/12 years; there were 6 males and 16 females. Ten patients had primary extraocular muscle surgery. Twelve patients were first treated with prednisone alone or prednisone and retrobulbar irradiation therapy (1000 RAD) and orbital decompression because of other ocular symptoms. All patients were euthyreotic at the time of operation, and their motility was unchanged for at least 6 months. Altogether 40 muscles were operated; most often recession of the inferior rectus (11 X) and recession of the medial rectus (9 X) were performed. All patients achieved orthophoria and a useful field of binocular single vision postoperatively.

Paresis and Restriction of the Inferior Rectus Muscle after Orbital Floor Fracture

Six patients had both restriction and paresis of the inferior rectus muscle after blowout fracture of the inferior orbital floor. All six were orthophoric in the primary position but had a severely constricted field of single binocular vision with troublesome diplopia on upgaze and downgaze. Recessing both the inferior rectus muscle and the superior rectus muscle in the injured eye greatly increased the field of single binocular vision. The symptoms improved in all six cases.

Evaluation of the Field of Binocular Single Vision in Incomitant Strabismus

Evaluation of the Field of Binocular Single Vision in Incomitant Strabismus

Measurement of the Field of Binocular Single Vision in the Evaluation of Incomitant Paralytic Strabismus

(1974). Measurement of the Field of Binocular Single Vision in the Evaluation of Incomitant Paralytic Strabismus. American Orthoptic Journal: Vol. 24, No. 1, pp. 77-82.