Strabismus - Fundamentals of Clinical Ophthalmology.pdf

STRABISMUS
(a)
(b)
(c)
(d)
Figure 6.16 Prism estimation of strabismus deviation. The divergent left eye was amblyopic from an injury in
childhood which damaged the macula. An appropriate prism in front of the fixing eye allows an assessment of
the amount of deviation consistent with Hering’s Law in contrast to the prism in front of the amblyopic eye
(a-c). (d) shows good cosmetic result following surgical correction
adults. Additional information may be obtained
in the adult because of greater cooperation,
particularly with diplopia tests, and forced
duction and force generation tests can be carried
out in the clinic without resorting to the need for
general anaesthesia.
In a comprehensive approach to the adult
patient suggestive of oculomotor dysfunction, it
is important that the examination take account
of a number of features, particularly about the
head and neck, that give clues to the oculomotor
system in strabismus in particular.
Head and neck features
●
●
Postures: abnormal head posture (AHP) (see
Figure 4.18), tilts, turns, chin up or down,
head tremors and head thrusting on
refixation, features of naevus flammeus.
Lid position with eye movements: palpebral
aperture changes with eye movements.
Detailed visual examination
Visual acuity, visual field and pupillary
responses.
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