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Published on: August 14, 2013
Decompensated strabismus after laser in situ keratomileusis
Journal of Cataract and Refractive Surgery
|November 24, 1999
Summary
Monovision after laser eye surgery can cause nerve IV palsy and vertical double vision. Patients may require prisms to correct this vision disturbance, highlighting the need for thorough pre-operative eye exams.
Area of Science:
- Ophthalmology
- Neuro-ophthalmology
Background:
- Bilateral laser in situ keratomileusis (LASIK) is a common refractive surgery.
- Monovision correction, where one eye is corrected for distance and the other for near, is an option for some patients.
Observation:
- A case of decompensated fourth nerve palsy presenting with vertical diplopia after bilateral LASIK with monovision correction is described.
- The patient experienced a decrease in vision in one eye, leading to an interruption of binocular fusion.
Findings:
- The diplopia was attributed to the monovision correction and subsequent disruption of fusion.
- Corrective spectacles were prescribed to equalize distance vision, but a prism was ultimately required to resolve the double vision.
Implications:
- Pre-operative assessment for refractive surgery candidates seeking monovision should include a careful cover-uncover test and versions assessment.
- A comprehensive ocular motility evaluation is recommended if any doubt exists regarding binocular vision status prior to monovision LASIK.
