Acute acquired concomitant esotropia and decompensated monofixation syndrome: a sensory-motor status assessment

Can J Ophthalmol. 2016 Aug;51(4):258-264. doi: 10.1016/j.jcjo.2016.02.003. Epub 2016 Jun 23.

Abstract

Objective: To assess and compare sensory-motor status and clinical features of type I and type II acute acquired concomitant esotropia (group A) and decompensated monofixation syndrome (group B).

Methods: In a retrospective, comparative study, 26 patients with a confirmed postoperative diagnosis of type I and II acute acquired concomitant esotropia and monofixation syndrome were enrolled. The 2-tailed unpaired t test and 2-tailed χ(2) test were performed to compare angle of deviation and sensory-motor status under the environmental conditions and after prismatic adaptation test and progressive prism test of 2 groups.

Results: All of the patients of group A and 4 patients (33%) of group B experienced diplopia under viewing conditions in the Worth's 4 dot and Bagolini striated glass tests. The TNO stereo test showed the total absence of stereopsis in 6 patients in group B and a significantly lower stereoacuity in group A in the remaining 6 patients (p < 0.0001). The prismatic adaptation test was positive in all of the patients in group B and in 10 patients (71%) in group A (p = 0.39). The value of the angle of deviation after the progressive prism test was significantly higher in group B than in group A (p = 0.02). At the end of the progressive prism test, all of the patients in group A and only 2 patients in group B were orthotropic (p = 0.01).

Conclusions: Bagolini striated glass and Worth's 4 dot tests under viewing conditions and responses under prisms allow for the differentiation of the 2 forms and lead to an accurate aesthetic and functional prognosis.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Depth Perception / physiology
  • Diplopia / physiopathology
  • Esotropia / diagnosis*
  • Esotropia / physiopathology
  • Eyeglasses
  • Female
  • Humans
  • Male
  • Oculomotor Muscles / physiopathology*
  • Psychomotor Performance / physiology*
  • Retrospective Studies
  • Vision Disparity / physiology*
  • Visual Acuity
  • Young Adult