Measuring the heterophoria: Agreement between two methods in non-presbyopic and presbyopic patients

Cantó-Cerdán, Mario; Cacho-Martínez, Pilar; García-Muñoz, Ángel

doi:10.1016/j.optom.2017.10.002

Cited by 17 publications

(24 citation statements)

References 27 publications

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“…In this study, we used the objectively neutralized cover test. Comparative studies of phorias measurement between the cover test and other techniques, conclude that the measure obtained by the cover test leads to lower magnitudes [27, 28]. However, the methodology applied in this study was the most suitable for the type of work performed, since it required the use of portable material to permit the evaluation of all the children in their normal school environment.…”

Section: Discussionmentioning

confidence: 99%

Convergence insufficiency and accommodative insufficiency in children

Nunes¹,

Monteiro²,

Ferreira³

et al. 2019

BMC Ophthalmol

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Purpose Convergence and accommodative insufficiency represent the main cause of complaints during close visual work and can reduce visual performance and comfort. Knowing their prevalence among schoolchildren is fundamental to define strategies for action. The purpose of this study was to estimate the frequency of these conditions in children in 5th and 6th school years in inland Portugal and to assess the impact that each visual condition has on their quality of life, based on the level of visual symptoms. Methods a cross-sectional study was carried out with children enrolled in the 5th and 6th school years. 372 children (192 girls) were assessed, with average ages of 10.9 ± 0.9 years. Refractive error and binocular vision assessment, integrating accommodative parameters, were used to analyse the visual condition. Symptoms were quantified using the Portuguese version of the CISS (Convergence Insufficiency Symptom Survey). Results The prevalence of definite Convergence Insufficiency (CI) in the children assessed was 2%. A prevalence of 6,8% could be considered if clinically significant CI (high suspect and definite categories) cases are accounted. In relation to Accommodative Insufficiency (AI), a frequency rate of 10% was recorded, with 3% of the evaluated children presenting AI and CI simultaneously. The symptoms score was higher in AI than in CI. Conclusions A frequency of approximately 10% was found for each one of the visual syndromes, and it was verified that visual discomfort is common among teenagers who carry these conditions. In cases of asthenopia, such as headaches and loss of concentration, associated with near vision activities, there is a requirement to evaluate the quality of binocular vision.

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Section: Discussionmentioning

confidence: 99%

Convergence insufficiency and accommodative insufficiency in children

Nunes¹,

Monteiro²,

Ferreira³

et al. 2019

BMC Ophthalmol

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“…Less agreement was reported for higher magnitudes of measurement by Mestre et al 26 One possible reason could be the number of participants presenting with larger magnitudes of heterophoria. Larger exophoria at near and certainly esophoric values at near viewing are less common in the population in general 35 and also in the sample included in this study, which results in larger variability.…”

Section: Discussionmentioning

confidence: 75%

Synchronization of a Removable Optical Element with an Eye Tracker: Test Case for Heterophoria Measurement

Gantz

Caspi

2020

Trans. Vis. Sci. Tech.

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Heterophoria describes the deviation of the optical axes in the absence of binocular fusion. Eye trackers (ET) can provide an objective assessment but are not broadly used clinically. We examined the feasibility of combining an infrared (IR) passfilter, IR detector, and an off-the-shelf ET. The proposed setup was validated against the broadly used cover test (CT). Furthermore, the setup was used to examine whether testing conditions can affect the measurements. Methods: An IR detector was attached to a handheld IR-pass filter that blocks visible light to provide occlusion while passing IR light for eye tracking. The detector senses the IR illumination of the eye tracker, creating a recordable signal of the occluder position synchronized with eye positions acquired by the SMI Red250 tracker. The mean of three measurements of each condition, three versus ten seconds occlusion, the occluded eye, and ET versus CT results were compared using the Wilcoxon test, correlation and Bland and Altman plots. Differences between measurements that were within 2 were considered clinically insignificant. Results: Thirty normally-sighted subjects (mean age 24.50 ± 2.20, range 20-28) with heterophoria ranging between 14 exophoria and 4 esophoria were recruited. There was no significant difference between the occluded eyes. However, there was a difference between 3 and 10 seconds' cover duration. The CT data were more similar to the 10 seconds cover duration, although differences were less than the clinical resolution of 2. Conclusions: An inexpensive off-the-shelf ET can be used to measure heterophoria with controlled testing parameters. Translational Relevance: Our study demonstrated a robust technique for synchronization of an optical element such as an IR cover, with an off-the-shelf commercial eye tracker. The synchronization of optical elements with eye tracking, which has been described here for heterophoria, can be adapted for other clinical measurements.

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“…To evaluate ocular alignment and detect the presence of horizontal heterophoria, two free-space methods were considered: the cover test 19 (objective method in which the examiner assesses the presence and level of misalignment) and the modified Thorington test 20 (subjective method based on patient-reported perception). The cover–uncover test was carried out to determine if there was strabismus, whereas the alternating cover test was used to quantify the magnitude of the deviation.…”

Section: Methodsmentioning

confidence: 99%

Binocular Vision in Patients with Multiple Sclerosis

Gil-Casas

Piñero

Molina‐Martín

2021

OPTO

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Purpose Oculomotor disorders have been reported in multiple sclerosis (MS) in up to 80% of cases. There have been studies evaluating binocular vision in several neurological diseases, but not in MS. Considering that a high percentage of eye-movement anomalies have been reported, the aim of this study was to analyze binocular vision in these subjects. Methods A total of 59 participants with MS — 21 with monocular optic neuritis, eleven with binocular optic neuritis, and 27 without optic neuritis — and 26 age-matched controls were enrolled. Binocular vision was analyzed using near point of convergence (NPC), positive and negative fusional vergence for far and near distance, measurement of heterophoria at both distances with cover and modified Thorington tests, and random-dot stereoscopy. Results The percentage of subjects with abnormal NPC values was highest in the MS group, followed by the MSONm (MS with optic neuritis in one eye), MSONb (MS with optic neuritis in both eyes), and control groups. MS patients showed an esophoric trend at near distance. Positive fusional vergence showed no significant differences between control and MS groups, but higher variability in recovery was found in MS groups. Negative fusional vergence at near distance showed significant differences between the control group and the two MS groups, with optic neuritis for both break-point and recovery values. A high percentage of patients with MS had alterations on stereopsis. Conclusion Alterations in binocular vision were present in MS, with divergence at near distance and stereopsis the most affected parameters. Likewise, MS patients with optic neuritis showed worse binocular vision.

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Measuring the heterophoria: Agreement between two methods in non-presbyopic and presbyopic patients

Cited by 17 publications

References 27 publications

Convergence insufficiency and accommodative insufficiency in children

Convergence insufficiency and accommodative insufficiency in children

Synchronization of a Removable Optical Element with an Eye Tracker: Test Case for Heterophoria Measurement

Binocular Vision in Patients with Multiple Sclerosis

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