Heidelberg Spectralis infrared video imaging: a clinical tool for diagnosing ocular torsional instability

The subjectivity of objective evaluation of torsion on fundus photographs by practicing strabismologists

“…[ 1 7 12 ] Apart from this, the measurement taken in monocular conditions may vary, and the variation may also occur when viewed with either eye fixing. [ 1 3 5 6 ] The limitation of assessing ocular torsion using indirect ophthalmoscopy include the position of the examiner, position of the patient, tilting of the head, usage of bright light, and continuous ocular movement. However, in uncooperative patients and young children, this method is commonly used.…”

“…However, in uncooperative patients and young children, this method is commonly used. [ 1 4 5 8 ] An important aspect where literature is lacking is in the variability and agreement in the grading of torsion by indirect ophthalmoscopy. The examiner is the most important variable even when the other factors are kept constant.…”

“…Ocular torsion can be measured by various techniques including indirect ophthalmoscopy, slit lamp biomicroscopy, fundus photography and disc foveal angle, retinal vasculature orientation and now recently using infrared imaging. [ 1 2 3 4 5 6 7 8 ] The commonly used objective techniques of assessing ocular torsion include the indirect ophthalmoscopy and fundus photography. There have been studies on the reliability of fundus photography,[ 9 ] reliability of slit lamp biomicroscopy,[ 10 ] and agreement of between double Maddox rod and Spierer's technique.…”

Reliability of Cyclotorsion measurements using Scanning Laser Ophthalmoscopy imaging in healthy subjects: the CySLO study

“…The same is, however, also true for the widely used RNFL measurements. A further limitation is that the measurement process itself possibly influences ocular torsion since SD-OCT/SLO devices do not record the movements of both eyes simultaneously as pointed out by Brodsky et al 3. So the presence of the camera in front of one eye provides a dissociating binocular stimulus.…”

“…Static ocular torsion accompanies conditions such as primary oblique muscle overaction, superior oblique palsy and skew deviation 3. Von Noorden et al 4 reported excyclotropia to be present in 76% of patients with unilateral superior oblique palsy.…”