J Korean Ophthalmol Soc.  2014 Jun;55(6):882-886.

Eye Fixation in Patients with Dissociated Vertical Diviation

• Kim JE
• Lee JH
• Rah SH

Abstract

PURPOSE
To clinically determine the proportion of people with a fixed dissociating eye in patients with dissociated vertical deviation (DVD).
METHODS
Medical records of 86 patients diagnosed with DVD in our department of ophthalmology from 2001 to November 2011 were retrospectively analyzed.
RESULTS
Of the 71 patients, 25 (35.21%) showed a higher degree of dissociation in the fixating eye, 26 (36.62%) had higher dissociation in the non-fixating eye; 20 of 25 patients with a higher level of dissociation in the fixating eye and 22 of 26 patients with a higher level of dissociation in the non-fixating eye received surgical correction for DVD, such as superior rectus muscle recession or inferior oblique muscle anterior transposition.
CONCLUSIONS
In DVD, the proportion of patients showing a higher level of dissociation in the fixating eye was significant. Patients with DVD require thorough evaluation; measurement of the level of dissociation and determination of the fixating eye is beneficial for management and surgical intervention.

Keyword

Dissociated vertical deviation (DVD); Fixating eye

MeSH Terms

Humans
Medical Records
Ophthalmology
Retrospective Studies

Reference

References

1. Wilson ME, McClatchey SK. Dissociated horizontal deviation. J Pediatr Ophthalmol Strabismus. 1991; 28:90–5.

2. Helveston EM. Dissociated vertical deviation-a clinical and labo-ratory study. Trans Am Ophthalmol Soc. 1980; 78:734–79.

3. Guyton DL. Dissociated vertical deviation: etiology, mechanism, and associated phenomena. Costenbader lecture. J AAPOS. 2000; 4:131–44.

4. Current concepts in Strabismus, Korean Association for Pediatric Ophthalmology and Strabismus. 2nd ed.Seoul: Naewae-haksool;2008. p. 239.

5. Bielschowsky A. Disturbances of the vertical motor muscles of the eye. Arch Ophthalmol. 1938; 20:175–200.

6. Spilmann A. A translucent occluder for studying eye position un-der unilateral or bilateral cover test. Am Orthopt J. 1986; 36:65–74.

7. Helveston EM. Dissociated vertical deviation-a clinical and labo-ratory study. Trans Am Ophthalmol Soc. 1980; 78:734–79.

8. Brodsky MC. Dissociated vertical divergence: perceptual corre-lates of the human dorsal light reflex. Arch Ophthalmol. 2002; 120:1174–8.

9. Freeman RS, Rosenbaum AL. Residual incomitant DVD following large bilateral superior rectus recession. J Pediatr Ophthalmol Strabismus. 1989; 26:76–80.

10. Scott WE, Sutton VJ, Thalacker JA. Superior rectus recessions for dissociated vertical deviation. Ophthalmology. 1982; 89:317–22.

11. Esswein Kapp MB, von Noorden GK. Treatment of residual dis-sociated vertical deviation with inferior rectus resection. J Pediatr Ophthalmol Strabismus. 1994; 31:262–4.

12. Burke JP, Scott WE, Kutschke PJ. Anterior transposition of the in-ferior oblique muscle for dissociated vertical deviation. Ophthalmology. 1993; 100:245–50.

13. Mims JL 3rd, Wood RC. Bilateral anterior transposition of the in-ferior obliques. Arch Ophthalmol. 1989; 107:41–4.

14. Kratz RE, Rogers GL, Bremer DL, et al. Anterior transposition of the inferior oblique muscle for dissociated vertical deviation. J Pediatr Ophthalmol Strabismus. 1989; 29:212–7.

15. Bacal DA, Nelson LB. Anterior transposition of the inferior obli-que muscle for both dissociated vertical deviation and/or inferior oblique overaction: results of 94 procedures in 55 patients. Binocular Vision & Eye Muscle Surgery. 1992; 7:219–25.

16. Duncan LB, von Noorden GK. Surgical results in dissociated verti-cal deviation. J Pediatric Ophthalmol strabismus. 1984; 21:25–7.

17. Clarke WN, Noel LP. Surgical results in intermittent exotropia. Can J Ophthalmol. 1981; 16:66–9.

18. Von Noorden GK, Campos EC. Binocular Vision and Ocular Motility. 6th ed.St. Louis (MO): Mosby;2002. p. 378–85.

19. Biglan AW, Davis JS, Cheng KP, Pettapiece MC. Infantile exotropia. J Pediatr Ophthalmol Strabismus. 1996; 33:79–84.

20. Coren S, Kaplan CP. Patterns of ocular dominance. Am J Optom & Arch Am Acad Optom. 1973; 50:283–92.

21. Han JH, Kim DS, Shin JC. Ocular dominance determined by near point of convergence test in intermittent exotropia. Korean J Ophthalmol. 2000; 41:1592–6.