Measurement of ductions and fields of binocular single vision (BSV): orthoptic practice in the UK and Ireland.

To evaluate the current clinical practice of quantifying ductions and fields of BSV in the UK and Ireland using an online questionnaire. An anonymous online questionnaire with twenty-one questions was distributed in February 2019 via the British and Irish Orthoptic Society (BIOS) members' newsletter. Objectives were to investigate: methods used, frequency of assessment, limiting factors and opinions of importance. Informed consent was gained to include the responses in the study. The data was analyzed using descriptive statistics and Wilcoxon Signed Ranks Testing. The questionnaire was completed by 105 orthoptists. The methods reported to quantify ductions and fields of BSV respectively were: Goldmann (33% and 34%), Aimark (22 and 23%), Lister (7%), Octopus (5 and 4%), Thomson ocular motility analyzer (2 and 3%), Binocular vision analyzer (2%) and no method reported (30% and 32%). The frequency of measuring ductions and fields of BSV per week (median 1-2) was significantly less than the number of patients seen with limited ocular motility per week (median 6-9). The main reasons for never or rarely measuring ductions or fields of BSV were not enough time, no method available and only on selected patients. Respondents indicated that they would measure ductions and fields of BSV more frequently if a quicker portable method was available (median 3-5 times per week). Most agreed that measurements of ductions and fields of BSV are important (89 and 95% respectively). There is no standardized method of quantitively measuring ductions or fields of BSV, with almost a third of respondents not measuring either. Although most orthoptists agreed these measurements are important, they are infrequently performed. The main factors limiting these assessments are insufficient time and lack of a testing method. If a faster portable device was available, orthoptists would measure ductions and fields of BSV more frequently.

Pilot Study Evaluating the Feasibility of Comparing Computer Game Play with Close Work During Occlusion in Children Aged 2-7 Years with Amblyopia.

BACKGROUND/AIMS: Computer games have been used to stimulate vision in amblyopia with varying degrees of success. The aim of this pilot study was to evaluate the feasibility of conducting a randomised controlled trial to test the effectiveness of computer game play compared to close work during occlusion treatment in children. METHOD: Children aged 2-7 years with amblyopia and no prior amblyopia treatment were invited to participate. Participants were randomised to a computer game group or close work group and asked to complete two hours occlusion per day, incorporating one hour of their allocated activity. LogMAR visual acuity (VA) was assessed before treatment commenced and after 7(±1) weeks. The same examiner, who was unaware of the allocated treatment, assessed the participant using the same VA test. RESULTS: Eighteen participants (mean age of 4.2 ± 1.3 years) completed the study. After seven weeks the mean VA of the amblyopic eye in the computer game group improved by 0.147 ± 0.182 logMAR, and in the close work group improved by 0.181 ± 0.124 logMAR. The difference in VA improvement between the computer game and the close work groups was not statistically significant (F(1,32) = 3.71; p = 0.06). CONCLUSION: No significant difference was found in visual outcomes between the two groups, but a larger sample size would be needed to draw conclusions regarding the amblyopic population. Evaluation of the study design suggests it would be feasible to conduct a randomised controlled trial comparing computer games and close work during occlusion to determine if a significant difference in visual outcome exists.

Benign recurrent sixth nerve palsy in an infant.

Acquired sixth nerve palsies in children are rare and may indicate serious underlying pathologies such as tumors, trauma, or raised intracranial pressure. A case of an infant with three episodes of benign sixth nerve palsy is presented.

Benign recurrent sixth nerve palsy in an infant.

Acquired sixth nerve palsies in children are rare and may indicate serious underlying pathologies such as tumors, trauma, or raised intracranial pressure. A case of an infant with three episodes of benign sixth nerve palsy is presented.