Sensorimotor Characteristics of Neuro-Ophthalmology and Oculo-Plastics Patients.

摘要: Background and purpose Certified orthoptists are routinely required, as a standard component of outpatient care, to examine identify the cause double vision described by neuro-ophthalmology oculo-plastics patients. Peer-reviewed articles in strabismus literature describing significance this role orthoptists, especially more complex cases strabismus, do exist, but outdated. The importance creating differential diagnosis understanding disease process is well-recognized medical education modern medicine. Patients method This work was retrospective chart review descriptive study most common clinical characteristics adult patients seen over 9-year period an orthoptist large, urban academic institution United States. History data obtained included demographic information; whether subjects were or oculo-plastic both; chief complaint; past history associated risk factors; ocular amblyopia; reported diplopia monocular binocular; visual acuities; sensorimotor examination fusion status presence absence ptosis; pupil size reactivity; basic accommodative function; physician diagnoses; suggested treatment diplopia. Results Five hundred seventy-five identified based on inclusion criteria. Racial demographics matched that state Maryland, with majority being Caucasian. minority Hispanic origin. Ninety-one percent cohort referred department at institution. Hypertension statistically significant factor for acquired cohort. Etiology close agreement final made referring physician. Pupil-sparing oculomotor palsy (third cranial nerve, CN3) occurred frequently pupil-involving CN3, tumor occurring etiology than aneurysm both groups. Trochlear nerve (CN4) often hydrocephalus abducens (CN6), trauma remained association CN4 palsy. In thyroid eye (TED), eso- exo-deviations similar frequency. As has been literature, concomitant myasthenia gravis (MG) rare these patients, although frequency types horizontal deviation. ptosis, asymmetry not predictive MG symmetry. Prism used frequently, followed surgery, address symptoms. Lastly, there female breast cancer no childhood amblyopia. Conclusion thorough assessment function, fusion, acuity provided important adjunct developing required make accurate diagnosis, which sometimes may subscribe accepted norms literature. also plays nonsurgical due strabismus. Fresnel Press-On™ ground-in spectacle prism commonly