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Ocular deviation following excimer laser photorefractive keratectomy
N Mandava1, E D Donnenfeld, P L Owens
1Department of Ophthalmology, Manhattan Eye, Ear, & Throat Hospital, New York, New York 10021, USA.
Journal of Cataract and Refractive Surgery
|May 1, 1996
Summary
Ocular deviation and double vision developed after excimer laser photorefractive keratectomy due to fusion breakdown. A cover test is recommended for refractive surgery candidates to detect significant phorias.
Area of Science:
- Ophthalmology
- Refractive Surgery
- Binocular Vision
Background:
- Excimer laser photorefractive keratectomy (PRK) is a common refractive surgery procedure.
- Maintaining binocular fusion is crucial for comfortable single vision.
Observation:
- A case of ocular deviation and diplopia (double vision) is presented.
- Symptoms developed nine months post-monocular PRK.
- The decompensation was attributed to a breakdown of fusional reserves at distance.
Findings:
- Monocular PRK can lead to decompensation of pre-existing or induced phorias.
- Distance fusion breakdown is a potential complication following refractive surgery.
- The cover test effectively identifies latent eye deviations (phorias).
Implications:
- Pre-operative screening for phorias using a cover test is essential for refractive surgery candidates.
- Identifying patients at risk for decompensation can prevent post-operative diplopia.
- This case highlights the importance of assessing binocular vision status before refractive surgery.