Relationship between Cornea and Lid Margin Position on the Appearance of Strabismus

Authors

Wang, Dong Hyun; Chang, Jee Ho

Relationship between Cornea and Lid Margin Position on the Appearance of Strabismus

publication date

Abstract/Introduction

Purpose

Previous strabismus appearance studies using images from real face photographs could not preclude the effect of other facial landmarks, such as position and contour of brow, nose, and facial outline, from pure effect of ocular deviation itself. With conceptualized drawings of eyes, we simulated strabismus deviation and collected the responses of observers.

Methods

The experiments consisted of three sessions: (1) one-eye, (2) two-eye cornea, and (3) two-eyelid deviation simulations. On a monitor, eight different ocular deviations in increments of 6 prism diopters of horizontal or vertical deviations were simulated. Nine ophthalmology residents were asked to choose between esotropia and exotropia for horizontal simulations and hypotropia or hypertropia for vertical simulations. Psychometric function fitting was performed. Detection sensitivity, point of subjective equality, and 95% thresholds were calculated.

Conclusion/Results

Results

Between cornea and lid deviation simulations, there was no difference in 95% thresholds, points of subjective equality, and sensitivity (all p values > 0.10), reflecting that the relative location of cornea and lid was the determinant factor in recognizing ocular deviation. The sensitivities of vertical deviation simulations were higher than that of horizontal in two-eye cornea and lid comparisons (p values < 0.04) but not in one-eye (p value = 0.37).

Conclusions

Our results suggest that the appearance of strabismus depends not on the absolute ocular alignment but rather on the reciprocal relationship of cornea and lid margin. Vertical misalignment was more apparent than horizontal misalignment.

Testimonials

I haven't actually used the optometrist side, so my review is limited to the vision therapy offered. This office was recommended by my occupational therapist for the treatment of my double vision following a stroke.

Claire A.

Love this location. I had a brain injury accident from day one one. All the team make you feel you still important and hope in the horizon after when the medical system fell you miserably. Dr. Ikeda very professional and very understanding about your issue. Two tombs up.

Jim K.

My husband and I were immediately impressed with Dr Ikeda. I was hit by a car while cycling which caused broken bones and three brain injuries. The brain injuries caused double vision. Dr. Ikeda examined my eyes and got me started on vision therapy with his occupational therapist who specializes in vision therapy. She (Chris) is absolutely great. I am impressed with the array of tools used to help recover my binocular vision. I am doing things I never thought were possible (balance boards etc). Chris pushes me and keeps me motivated. I really enjoy my sessions with her. The office staff is always friendly and they have a wonderful appointment reminder tool that makes it easy to keep my calendar up to date. I am happy the rehab center at Little Co. of Mary recommended them!!

Teresa S.

The Vision Therapy is handled in a separate office through a different door from the shared waiting room. Chris, the vision therapist, has a wide and varied assortment of tools, equipment and resources to best evaluate and treat most vision issues. After just a few visits, my double vision became easier to control, using exercises developed during the therapy process. It was time well-spent.

Joe M.

I have been coming here since I can remember. I love it here. The staff is so amazing and nice. They explain everything they gonna do and never make you feel rushed. Dr. Ikeda has always been my doctor and I would never want another one. He is the doctor for my whole family and is always asking how everyone is doing. I am also so crazy about picking out my frames and have to try so many and each person who helps me take the time and lets me try them all on. I would never want to go anywhere else! I definitely would recommend this office to anyone looking for a great eye doctor.

Kayla W.

This is not for the eye exam but for the frames selection portion. I brought my prescription from Kaiser here with my VSP insurance. The reception staff was very polite and professional. Manny helped me to pick out frames and explain my coverage. Very helpful and patient not like the individual at the other place I rated here on Yelp. I was running late and he still helped me and was not bothered at all. I am so glad I came here ..........very pleased.

Very professional staff and pleasant.