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Related Experiment Videos

Saccadic velocity analysis in patients with divergence paralysis

L Lim1, A L Rosenbaum, J L Demer

  • 1Jules Stein Eye Institute, Department of Ophthalmology, Los Angeles, CA 90024, USA.

Journal of Pediatric Ophthalmology and Strabismus
|March 1, 1995
PubMed
Summary

Divergence paralysis involves mildly reduced saccadic velocities in abduction, distinct from lateral rectus palsy. Surgical resection of bilateral lateral rectus muscles effectively treats this condition.

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Area of Science:

  • Ophthalmology
  • Neuroscience

Background:

  • Divergence paralysis is a clinical condition affecting eye movement.
  • Its relationship to abducens nerve palsy and the existence of a divergence center are debated.

Purpose of the Study:

  • To investigate the characteristics of horizontal saccadic velocity in patients with divergence paralysis.
  • To differentiate divergence paralysis from abducens nerve palsy.
  • To evaluate the efficacy of strabismus surgery for divergence paralysis.

Main Methods:

  • Horizontal saccadic velocity testing using electro-oculography in 12 patients with divergence paralysis and 12 age-matched controls.
  • Measurement of peak saccadic velocities during 10, 20, and 30-degree saccades in adduction and abduction.
  • Surgical intervention involving bilateral lateral rectus muscle resection in five patients.

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Main Results:

  • Patients with divergence paralysis showed normal saccadic velocities in adduction and 10-degree abduction.
  • Mildly reduced saccadic velocities were observed in 20-degree and 30-degree abducting saccades compared to controls.
  • Strabismus surgery (bilateral lateral rectus resection) effectively corrected esotropia in distance viewing without overcorrection at near.

Conclusions:

  • The findings support divergence paralysis as a distinct clinical entity, separate from abducens nerve paresis.
  • Evidence suggests the existence of an active divergence center in the brain.
  • Bilateral lateral rectus muscle resection is a successful therapeutic approach for divergence paralysis.