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Divergence insufficiency.

A H Thomas1

  • 1University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|December 22, 2000
PubMed
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Divergence insufficiency, a condition causing double vision at a distance, can be effectively treated. Surgical recession of the medial rectus muscles resolves symptoms in otherwise healthy patients.

Area of Science:

  • Ophthalmology
  • Neuro-ophthalmology
  • Strabismus

Background:

  • Divergence insufficiency is a rare form of strabismus.
  • It presents as esotropia and diplopia specifically at distance.
  • Patients maintain single binocular vision at near distances.

Purpose of the Study:

  • To describe the diagnosis and treatment of divergence insufficiency.
  • To differentiate this condition from other strabismic entities.
  • To report outcomes in a series of patients.

Main Methods:

  • A retrospective case series of seven patients.
  • Patients were healthy, aged 9 to 41 years.
  • Acquired esotropia at distance was treated with medial rectus recession (unilateral or bilateral).

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Main Results:

  • All seven patients experienced resolution of distance diplopia.
  • One patient required a secondary bilateral recession after initial unilateral surgery.
  • The treatment was successful in resolving the primary symptom.

Conclusions:

  • Divergence insufficiency is a distinct clinical entity.
  • It affects otherwise healthy individuals.
  • Unilateral or bilateral medial rectus recession is a successful treatment approach.