Using of Hypercorrection in Diagnostics and Functional Treatment of Children with Strabismus
Open Access
- 24 September 2020
- journal article
- Published by PE Polunina Elizareta Gennadievna in Ophthalmology in Russia
- Vol. 17 (3), 442-450
- https://doi.org/10.18008/1816-5095-2020-3-442-450
Abstract
Conjunctival lymphomas are predominantly extranodal B-cell non-Hodgkin’s lymphomas (NHL), most of them are MALT-lymphomas originating from the mucosa-associated lymphoid tissue. The paper is devoted to the study of the feasibility of using hypercorrection in the functional treatment of children with non-paralytic strabismus.The purpose of this work is evaluation of the effectiveness of hypercorrection in the diagnosis and functional treatment of children with non-paralytic strabismus. Patients and methods. We observed 166 school-age children with friendly strabismus: 140 children with esotropia (134 children with hypermetropic refraction and 6 children with myopic refraction) and 26 children with exotropia (17 children with myopic refraction and 9 children with hypermetropic refraction). The control group of children included 151 school-age children with ametropia without strabismus: 110 children with hypermetropia and 41 children with myopia. Optimal optical correction, accommodation and visual acuity were studied under monocular observation conditions and then under bifixation control using a binarimeter at different distances from the eyes (0.5, 1, and 5 m).Results. In children with esotropia and hypermetropic refraction, the most favorable conditions for the formation of a binocular visual image (BVI) were created using hypercorrection (average values from 2.4 ± 0.06 to 2.8 ± 0.06 D for different distances from the eyes). Children with exotropia and myopic refraction also needed hypercorrection to form BVI (Me = 2.5 [Q1 = 2.0; Q3 = 3.0] D at all distances from the eyes). At the same time, a strong positive correlation was found between the deviation value and the hypercorrection value necessary for the formation of BVI in children with both esotropia and exotropua (r = 0.85, p < 0.001 and r = 0.8, p < 0.001, respectively). In children with “inappropriate” refraction (myopic with esotropia and hypermetropic — with exotropia), BVI was easier to occur and better maintained under hypocorrection by an average of 1.75 ± 0.06 d. In the control group of children, the maximum visual acuity under the control of BVI was observed with the strength of correcting lenses 0.5 D less compared to monocular conditions of the study.Conclusion. The effectiveness of using hypercorrection in children with non-paralytic strabismus and “appropriate” refraction for the formation of BVI on a binarimeter is shown. In this case, the value of hypercorrection has a direct dependence on the value of deviation, which is consistent with the principles of accommodation-convergent synkinesia. In children with non-paralytic strabismus and “inappropriate” refraction, more favorable conditions for the formation of BVI are created when using hypocorrection. The result of functional treatment on a binarimeter with an individual selection of optimal optics for performing exercises is an improvement of accommodation, binocular and stereo vision, an increase of fusion reserves and visual acuity.Keywords
This publication has 8 references indexed in Scilit:
- The relationship of monocular and binocular mechanisms of spatial perception before and after functional treatment in children with postoperative residual microdeviationFyodorov journal of ophthalmic surgery, 2019
- Overcorrecting minus lens therapy in patients with intermittent exotropia: Should it be the first therapeutic choice?International Ophthalmology, 2016
- Symptoms in Children with Convergence InsufficiencyOptometry and Vision Science, 2012
- Intervention for intermittent distance exotropia with overcorrecting minus lensesEye, 2007
- Accommodation stimulus–response function and retinal image qualityVision Research, 2006
- StrabismusPediatric Clinics of North America, 2003
- Does Overcorrecting Minus Lens Therapy for Intermittent Exotropia Cause Myopia?American Journal of Ophthalmology, 1999
- Overcorrecting Minus Lens Therapy for Treatment of Intermittent ExotropiaOphthalmology, 1983