Orthoptic Vision Therapy: Establishing a Protocol for Management of Diplopia Following Orbital Fracture Repair.
J Craniofac Surg
; 32(3): 1025-1028, 2021 May 01.
Article
em En
| MEDLINE
| ID: mdl-32969940
ABSTRACT
INTRODUCTION:
Persistent diplopia following orbital fracture is a well-recognized problem. While observation is the standard-of-care, symptoms may be protracted. Orthoptic vision therapy is a form of ocular physical therapy that achieves functional rehabilitation through targeted exercises. This study presents a protocol for post-traumatic orthoptics and describes preliminary results. MATERIALS ANDMETHODS:
Protocols for home-therapy/office-assessment were developed using commercial software and exercises targeting motility and fusion. Office-assessment also included validated questionnaire chronicling symptomatology. Healthy-volunteers (nâ=â10) trailed the protocol three times (nâ=â30) and normative data was compiled. Comparative measurements were made in chronic (>1year; nâ=â8) and acute (<2 weeks; nâ=â4) fracture cohorts. Time-of-therapy was recorded, monetary cost-analysis performed, and side-effects assessed.RESULTS:
Severe/moderate motility limitation was found in 3 of 4 acute fracture patients but not in chronic or healthy cohorts. The acute cohort had worse fusion when comparing convergence (mean break/recovery of 8.0/6.5 prism diopters (pd) versus 31.87/21.23pd; Pâ=â0.001/0.015) and divergence (3.00/1.50pd versus 18.37/12.83pd; Pâ=â0.000/0.001) to the healthy cohort. Those with chronic fracture had lower convergence (15.71/5.00pd; Pâ=â0.01/0.001) and divergence (12.29/4.71pd; Pâ=â0.04/0.002) when compared with healthy subjects, but better function than acute patients. Acute fracture patients reported greater symptomatology than chronic (mean score 18.8 versus 4.6; Pâ=â0.003) or healthy (5.0; Pâ=â0.02) groups, but there was no difference between chronic and healthy groups (Pâ=â0.87). Assessment took <10 minutes. Per patient software cost was <$70. Mild eyestrain related to therapy was self-resolving in all cases.CONCLUSIONS:
Orthoptic therapy may improve fusion and motility following orbital fracture. This protocol serves as basis for prospective work.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Fraturas Orbitárias
/
Transtornos da Motilidade Ocular
Tipo de estudo:
Etiology_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article