Observations about objective and subjective ocular torsion.

Area of Science:

• Ophthalmology
• Neuroscience
• Vision Science

Background:

• Cyclovertical strabismus presents complex visual challenges.
• Understanding torsional deviations is crucial for effective management.
• Differentiating objective and subjective torsion aids in diagnosis.

Purpose of the Study:

• To examine the relationship between objective and subjective torsion in cyclovertical strabismus.
• To determine if objective torsion varies with the fixing eye.
• To clarify the clinical significance of torsion assessment.

Main Methods:

• Prospective evaluation of objective and subjective torsion tests.
• Inclusion of 36 patients with diverse cyclovertical strabismus.
• Assessment using the double Maddox rod for subjective torsion and masked fundus photography for objective torsion.

Main Results:

• Objective torsion remained consistent irrespective of the fixing eye.
• Prolonged occlusion of the non-affected eye increased objective torsion in that eye.
• Subjective torsion was often absent in patients lacking bifoveal fusion but correlated with objective torsion in those with bifoveal potential.

Conclusions:

• Objective and subjective torsion assessments are vital yet distinct in evaluating cyclovertical strabismus.
• No immediate torsional motor shift occurs upon switching fixation.
• Prolonged fixation with the affected eye may induce motor torsional changes in the non-affected eye.