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Journal of Optometry 2022Convergence insufficiency (CI) is a common binocular vision (BV) disorder characterized by difficulty in maintaining motor fusion at near, which affects approximately... (Review)
Review
Convergence insufficiency (CI) is a common binocular vision (BV) disorder characterized by difficulty in maintaining motor fusion at near, which affects approximately 7.5 percent of the population. Diagnostic criteria for the disorder are inconsistent, ranging from one to many clinical signs. Methodology for clinical tests is inconsistent in measurement technique, visual targets, required repetitions, and normative values. This manuscript demonstrates the inconsistencies amongst published studies, and highlights the importance of consistent clinical diagnostic signs, measurement techniques, visual targets, and cut-off criteria. For each clinical sign, the recommended methodology for the procedure is described. Several studies do not take age into account when diagnosing CI in their cohorts. As such, the review emphasizes changes in diagnostic signs with age. This manuscript highlights the need for consistent and clear procedures and diagnostic criteria amongst clinicians and provides the basis for future studies in terms of diagnostic testing required for CI of varying age groups.
Topics: Accommodation, Ocular; Convergence, Ocular; Humans; Ocular Motility Disorders; Vision Disorders; Vision, Binocular
PubMed: 34963569
DOI: 10.1016/j.optom.2021.11.002 -
The American Journal of Sports Medicine Oct 2014Vestibular and ocular motor impairments and symptoms have been documented in patients with sport-related concussions. However, there is no current brief clinical screen...
BACKGROUND
Vestibular and ocular motor impairments and symptoms have been documented in patients with sport-related concussions. However, there is no current brief clinical screen to assess and monitor these issues.
PURPOSE
To describe and provide initial data for the internal consistency and validity of a brief clinical screening tool for vestibular and ocular motor impairments and symptoms after sport-related concussions.
STUDY DESIGN
Cross-sectional study; Level of evidence, 2.
METHODS
Sixty-four patients, aged 13.9 ± 2.5 years and seen approximately 5.5 ± 4.0 days after a sport-related concussion, and 78 controls were administered the Vestibular/Ocular Motor Screening (VOMS) assessment, which included 5 domains: (1) smooth pursuit, (2) horizontal and vertical saccades, (3) near point of convergence (NPC) distance, (4) horizontal vestibular ocular reflex (VOR), and (5) visual motion sensitivity (VMS). Participants were also administered the Post-Concussion Symptom Scale (PCSS).
RESULTS
Sixty-one percent of patients reported symptom provocation after at least 1 VOMS item. All VOMS items were positively correlated to the PCSS total symptom score. The VOR (odds ratio [OR], 3.89; P < .001) and VMS (OR, 3.37; P < .01) components of the VOMS were most predictive of being in the concussed group. An NPC distance ≥5 cm and any VOMS item symptom score ≥2 resulted in an increase in the probability of correctly identifying concussed patients of 38% and 50%, respectively. Receiver operating characteristic curves supported a model including the VOR, VMS, NPC distance, and ln(age) that resulted in a high predicted probability (area under the curve = 0.89) for identifying concussed patients.
CONCLUSION
The VOMS demonstrated internal consistency as well as sensitivity in identifying patients with concussions. The current findings provide preliminary support for the utility of the VOMS as a brief vestibular/ocular motor screen after sport-related concussions. The VOMS may augment current assessment tools and may serve as a single component of a comprehensive approach to the assessment of concussions.
Topics: Adolescent; Athletic Injuries; Brain Concussion; Case-Control Studies; Child; Cross-Sectional Studies; Female; Humans; Male; Multivariate Analysis; Neurologic Examination; Ocular Motility Disorders; Post-Concussion Syndrome; ROC Curve; Vestibular Diseases
PubMed: 25106780
DOI: 10.1177/0363546514543775 -
Deutsches Arzteblatt International Sep 2018
Topics: Child; Child, Preschool; Humans; Ocular Motility Disorders; Scoliosis
PubMed: 30282579
DOI: 10.3238/arztebl.2018.0609a -
Journal of Binocular Vision and Ocular... 2019Amblyopia is a neurodevelopmental disorder of the visual system, as a result of discordant visual experience during infancy or early childhood. Because amblyopia is... (Review)
Review
Amblyopia is a neurodevelopmental disorder of the visual system, as a result of discordant visual experience during infancy or early childhood. Because amblyopia is typically defined as monocularly reduced visual acuity accompanied by one or more known amblyogenic factors, it is often assumed that the fellow eye is normal and sufficient for tasks like reading and eye-hand coordination. Recent scientific evidence of ocular motor, visual, and visuomotor deficits that are present with fellow eye monocular viewing and with binocular viewing calls this assumption into question. This clinical update reviews the research that has revealed fellow ocular motor and visual deficits and the effect that these deficits have on an amblyopic child's visuomotor and visuocognitive skills. We need to understand how to prevent and rehabilitate the effects of amblyopia not only on the nonpreferred eye but also on the fellow eye.
Topics: Amblyopia; Child; Diagnostic Techniques, Ophthalmological; Humans; Ocular Motility Disorders; Perceptual Disorders; Physical Examination; Psychomotor Performance; Vision, Binocular; Visual Acuity
PubMed: 31161888
DOI: 10.1080/2576117X.2019.1624440 -
Journal of Optometry 2020
Topics: Evidence-Based Practice; Humans; Ocular Motility Disorders; Optometry
PubMed: 32553271
DOI: 10.1016/j.optom.2020.06.001 -
Practical Neurology Oct 2018Ocular neuromyotonia is a rare, albeit treatable, ocular motor disorder, characterised by recurrent brief episodes of diplopia due to tonic extraocular muscle...
Ocular neuromyotonia is a rare, albeit treatable, ocular motor disorder, characterised by recurrent brief episodes of diplopia due to tonic extraocular muscle contraction. Ephaptic transmission in a chronically damaged ocular motor nerve is the possible underlying mechanism. It usually improves with carbamazepine. A 53-year-old woman presented with a 4-month history of recurrent episodes of binocular vertical diplopia (up to 40/day), either spontaneously or after sustained downward gaze. Between episodes she had a mild left fourth nerve palsy. Sustained downward gaze consistently triggered downward left eye tonic deviation, lasting around 1 min. MR scan of the brain was normal. She improved on starting carbamazepine but developed a rash that necessitated stopping the drug. Switching to lacosamide controlled her symptoms.
Topics: Female; Fixation, Ocular; Humans; Isaacs Syndrome; Middle Aged; Ocular Motility Disorders
PubMed: 29467180
DOI: 10.1136/practneurol-2017-001866 -
BMJ Case Reports Feb 2017
Topics: Adolescent; Gait Ataxia; Humans; Male; Myoclonus; Ocular Motility Disorders
PubMed: 28202488
DOI: 10.1136/bcr-2017-219433 -
Journal of Clinical Neurophysiology :... Nov 2019The cerebellum works as a network hub for optimizing eye movements through its mutual connections with the brainstem and beyond. Here, we review three key areas in the... (Review)
Review
The cerebellum works as a network hub for optimizing eye movements through its mutual connections with the brainstem and beyond. Here, we review three key areas in the cerebellum that are related to the control of eye movements: (1) the flocculus/paraflocculus (tonsil) complex, primarily for high-frequency, transient vestibular responses, and also for smooth pursuit maintenance and steady gaze holding; (2) the nodulus/ventral uvula, primarily for low-frequency, sustained vestibular responses; and (3) the dorsal vermis/posterior fastigial nucleus, primarily for the accuracy of saccades. Although there is no absolute compartmentalization of function within the three major ocular motor areas in the cerebellum, the structural-functional approach provides a framework for assessing ocular motor performance in patients with disease that involves the cerebellum or the brainstem.
Topics: Animals; Cerebellum; Eye Movements; Humans; Ocular Motility Disorders
PubMed: 31688323
DOI: 10.1097/WNP.0000000000000579 -
Tidsskrift For Den Norske Laegeforening... Aug 2019Multiple sclerosis can give rise to signs and symptoms from the entire nervous system, including visual impairments. Visual impairments often go unreported because they... (Review)
Review
Multiple sclerosis can give rise to signs and symptoms from the entire nervous system, including visual impairments. Visual impairments often go unreported because they are not obvious to patients, which means that doctors must ask about them specifically. Regular monitoring of vision is important, however, to provide personalised rehabilitation and assistive technologies, and thereby improve patients’ functioning and quality of life.
Topics: Cranial Nerve Diseases; Humans; Multiple Sclerosis; Nystagmus, Pathologic; Ocular Motility Disorders; Optic Neuritis; Quality of Life; Vision Disorders
PubMed: 31429247
DOI: 10.4045/tidsskr.18.0786 -
Schizophrenia Bulletin Mar 2017The visual tract is prominently involved in schizophrenia, as evidenced by perceptual distortions and a type of nystagmus found in many individuals affected. Genetic... (Review)
Review
The visual tract is prominently involved in schizophrenia, as evidenced by perceptual distortions and a type of nystagmus found in many individuals affected. Genetic explanations for these abnormalities have been suggested. This study proposes an alternate explanation based on infection. Several infectious agents thought to be associated with some cases of schizophrenia are known to cause both infection of the fetus and abnormalities of the eye. Toxoplasma gondii is examined in detail, and rubella, cytomegalovirus, varicella-zoster virus, and herpes simplex virus more briefly. Careful ophthalmic assessments, including funduscopy and direct examination of tissues for infectious agents, will clarify the role of such agents in ocular aspects of schizophrenia.
Topics: Eye Diseases; Female; Herpesviridae Infections; Humans; Ocular Motility Disorders; Perceptual Disorders; Pregnancy; Pregnancy Complications, Infectious; Rubella Syndrome, Congenital; Schizophrenia; Toxoplasmosis, Ocular; Visual Perception
PubMed: 27507268
DOI: 10.1093/schbul/sbw113