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Vision therapy management for dissociated horizontal deviation.

Yi Pang1, Kelly A Frantz, Darrell G Schlange

  • 1Illinois College of Optometry, Chicago, Illinois 60616, USA. ypang@)ico.edu

Optometry and Vision Science : Official Publication of the American Academy of Optometry
|October 5, 2012
PubMed
Summary
This summary is machine-generated.

Vision therapy (VT) successfully managed dissociated horizontal deviation (DHD) in two patients, improving eye alignment control. This approach offers a potential alternative to surgery for this rare strabismus subtype.

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Area of Science:

  • Ophthalmology
  • Neuroscience

Background:

  • Dissociated horizontal deviation (DHD) is a rare strabismus variant where eye alignment changes based on fixation, independent of accommodation.
  • DHD can present as both esotropia (ET) and exotropia (XT) in the same individual, complicating management.
  • Surgical interventions for DHD often require multiple procedures.

Observation:

  • Two cases of DHD were managed using vision therapy (VT).
  • Case 1: A 9-year-old girl with DHD (15Δ left ET to 15Δ alternating XT) showed improved binocular vision and no strabismus post-VT.
  • Case 2: A 40-year-old man with DHD (5Δ ET to 15Δ XT) and double vision experienced normal binocular function and no strabismus post-VT, with sustained results over 16 years.

Findings:

  • Vision therapy effectively improved eye alignment control in both DHD cases.
  • Binocular vision functions normalized in both patients following VT.
  • Long-term follow-up demonstrated sustained control of strabismus in one case.

Implications:

  • Vision therapy presents a viable, non-surgical management option for DHD.
  • Eye care practitioners should consider VT for DHD, recognizing that extended therapy may be necessary.
  • These findings highlight VT's potential in managing complex strabismus subtypes.