By Alec M. Ansons
Manchester Royal Eye sanatorium, Oxford, united kingdom. continues the fundamental framework of the former version, c1991, and contains a new bankruptcy on an 'Introduction to Concomitant Strabismus,' with all different chapters revised and up to date. Halftone illustrations. DNLM: Ocular Motility Disorders--diagnosis.
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Additional info for Diagnosis and Management of Ocular Motility Disorders
Pho tore fraction Photorefraction is a technique in which the light from a camera flash is changed by the optics of the eye and reflected back from the retina to form a blur circle. The circle can be seen superimposed on the cornea. The refractive error is determined from the size and shape of the blur circle. Photorefraction was developed by Howland and Howland (1974),using an orthogonal photorefractor which photographed the eyes through a segmented cylindrical lens. This apparatus was adapted by Howland et al.
Keratornetry Refraction 29 ON-AXIS (ISOTROPIC) PHOTOREFRACTION The subject is placed so that his eyes are 75 mm from the camera, on eye level with it. He must look directly at the camera and the photographer must be directly behind the apparatus. Three photographs are taken with the camera focused at different distances: at 75 cm with the eyes in focus; at 150 and 50 cm with the eyes out of focus. Blur circles result from the two defocused photographs, which are examined for size and shape. In hypermetropia the blur circle is smaller than the circle from an emmetropic eye, in myopia it is larger and in astigmatism it is elliptical, with the long axis of the ellipse coincident with the more defocused axis of the astigmatism.
The patient will almost certainly require his correction again as he becomes older, and in any case the exotropia is likely to increase, therefore it is preferable to prescribe the optimum correction for visual acuity and comfort and to treat the deviation surgically when the patient’s appearance warrants it. Myopia Myopia presents more of a problem: undercorrection cannot be achieved without reduction in visual acuity. Overcorrection or minus lenses can be used in the treatment of exotropia. Patients with esotropia or esophoria must be given a correction which results in a reasonable level of vision: 6/9 is usually the minimum which patients with potential 6/5 vision will accept.
Diagnosis and Management of Ocular Motility Disorders by Alec M. Ansons