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Diagnostic occlusion test for acquired esotropia.

Alaa AlAli1, Sadik Taju Sherief1, Katelyn MacNeill1

  • 1Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ont.

Canadian Journal of Ophthalmology. Journal Canadien D'Ophtalmologie
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The 45-minute diagnostic occlusion test (DOT) significantly increases measured esodeviation in patients with acquired esotropia. This test helps reveal the full deviation, potentially preventing surgical undercorrection.

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Area of Science:

  • Ophthalmology
  • Strabismus Research
  • Clinical Diagnostics

Background:

  • Acquired esotropia is a condition characterized by inward turning of the eyes.
  • Accurate measurement of esodeviation is crucial for effective treatment planning, particularly before surgical intervention.
  • Tonic fusional divergence can mask the true extent of deviation in esotropic patients.

Purpose of the Study:

  • To evaluate the impact of the 45-minute diagnostic occlusion test (DOT) on the measured esodeviation in individuals with acquired esotropia.
  • To determine if the DOT can reveal a larger deviation than standard measurements.
  • To assess the potential of the DOT in improving surgical planning for acquired esotropia.

Main Methods:

  • Sixty-seven patients diagnosed with acquired esotropia were enrolled.
  • Participants were randomly assigned to a patch group (n=37) or a control group (n=30).
  • Esodeviation was measured at distance and near before and after a 45-minute DOT in the patch group.

Main Results:

  • The DOT significantly increased esodeviation measurements in the patch group, both at distance (6.4 PD increase, p=0.0001) and near (8.6 PD increase, p=0.001).
  • Approximately 70.1% of patients in the patch group showed a change of >5 PD at near after the DOT.
  • The control group showed no significant change in esodeviation measurements, indicating the DOT's effect.

Conclusions:

  • The diagnostic occlusion test (DOT) effectively reveals a greater degree of esodeviation in patients with acquired esotropia.
  • Implementing the DOT can help mitigate the risk of surgical undercorrection by accounting for tonic fusional divergence.
  • The DOT is a valuable clinical tool for accurate esodeviation measurement in acquired esotropia.