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Predicting postoperative paradoxical diplopia.

Claire Castleberry, Kyle Arnoldi

The American Orthoptic Journal

|December 15, 2010

Summary

Fovea-to-fovea tests are more effective than fovea-to-periphery tests for diagnosing anomalous retinal correspondence (ARC) and predicting postoperative double vision in adult strabismus patients.

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Area of Science:

Ophthalmology
Neuroscience
Vision Science

Background:

Anomalous retinal correspondence (ARC) enables single binocular vision in strabismus by linking noncorresponding retinal elements.
Surgical strabismus correction in ARC patients can cause temporary paradoxical diplopia.

Purpose of the Study:

To compare the effectiveness of fovea-to-fovea and fovea-to-periphery tests in predicting postoperative diplopia.
To evaluate diagnostic accuracy for ARC in adult strabismus patients.

Main Methods:

Retrospective study of adult strabismus patients with ARC.
Preoperative diagnosis of ARC using fovea-to-fovea and fovea-to-periphery tests.
Correlation of test results with postoperative diplopia occurrence.

Main Results:

62% of patients experienced temporary postoperative diplopia.
100% of diplopic patients showed ARC on preoperative fovea-to-fovea tests.
Fovea-to-periphery tests had poor predictive value for postoperative diplopia.

Conclusions:

Fovea-to-fovea tests are superior to fovea-to-periphery tests for detecting ARC.
Fovea-to-fovea tests effectively predict postoperative diplopia in adult strabismus patients with ARC.

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