Clinical Orthoptics has become established as a basic reference text providing fundamental information on anatomy, innervation and orthoptic investigation, plus diagnosis and management of strabismus, ocular motility and related disturbances. It is aimed at trainee ophthalmologists and orthoptic undergraduate students. Qualified orthoptists, general ophthalmologists and optometrists will also find valuable guidance in these pages. In this edition, the author has maintained the goal of producing a user-friendly, clinically relevant and succinct book, while revising it to reflect a variety of developments in the field.

FEATURES

• Essential reading for students of orthoptics and ophthalmolology
• Now fully revised and updated
• Generously illustrated with photographs and line drawings
• Includes diagnostic aids, case reports, and helpful glossary

Autorentext
Fiona J. Rowe is Lecturer in Orthoptics at the University of Liverpool and an Honorary Research Vision Scientist at the Department of Orthoptics and Ophthalmology, Warrington Hospital. Dr Rowe also lectures extensively to trainee and qualified ophthalmologists, ophthalmic nurses, and other members of the multi-disciplinary eye care team.

Inhalt

Preface xi

Acknowledgements xii

List of Figures xiii

List of Tables xvii

Section I 1

1 Extraocular Muscle Anatomy and Innervation 3

Muscle pulleys 3

Ocular muscles 5

Innervation 10

Associated cranial nerves 12

References 15

Further reading 16

2 Binocular Single Vision 17

Worth's classification 17

Development 17

Retinal correspondence 19

Physiology of stereopsis 20

Fusion 23

Retinal rivalry 24

Suppression 24

Diplopia 25

References 27

Further reading 28

3 Ocular Motility 29

Saccadic system 29

Smooth pursuit system 31

Vergence system 33

Vestibular-ocular response and optokinetic response 35

Brainstem control 37

Muscle sequelae 39

Past-pointing 40

Bell's phenomenon 41

References 41

Further reading 43

4 Orthoptic Investigative Procedures 45

Visual acuity 45

Cover test 60

Ocular motility 64

Accommodation and convergence 68

Retinal correspondence 73

Fusion 77

Stereopsis 82

Suppression 89

Synoptophore 91

Aniseikonia 97

Fixation 98

Measurement of deviations 99

Hess charts 105

Field of binocular single vision 108

Uniocular field of vision 110

Measurement of torsion 111

Parks-Helveston three-step test 113

Diplopia charts 113

Bielchowsky phenomenon (dark wedge test) 115

Forced duction test 115

Forced generation test 115

Orthoptic exercises 115

References 119

Further reading 124

Section II 129

5 Heterophoria 131

Classification 131

Aetiology 131

Causes of decompensation 132

Esophoria 132

Exophoria 132

Hyperphoria/hypophoria 133

Alternating hyperphoria 133

Alternating hypophoria 133

Cyclophoria 133

Incomitant heterophoria 133

Hemifield slide 133

Investigation of heterophoria 134

Management 135

References 136

Further reading 137

6 Heterotropia 138

Esotropia 138

Factors necessary for development of binocular single vision 139

Constant esotropia with an accommodative element 140

Constant esotropia without an accommodative element 141

Accommodative esotropia 146

Relating to fixation distance 151

Exotropia 155

Hypertropia 168

Hypotropia 168

Cyclotropia 169

Dissociated vertical deviation 170

Dissociated horizontal deviation 172

Quality of life 173

Pseudostrabismus 174

References 175

Further reading 184

7 Microtropia 189

Terminology 189

Classification 190

Investigation 191

Management 194

References 194

Further reading 195

8 Amblyopia and Visual Impairment 197

Classification 197

Aetiology 197

Investigation 198

Management 199

Eccentric fixation 205

Cerebral visual impairment 205

Delayed visual maturation 206

PHACE syndrome 207

References 207

Further reading 212

9 Aphakia 215

Methods of correction 215

Investigation 215 Problems with unilateral aphakia 21...