The Effect of Conservative Therapy on Diplopia in Patients with Paralytic Strabismus

Czech version

Authors: L. Pražáková ¹; J. Timkovič ^2–4; R. Autrata ^3,5; P. Rezek ¹; P. Novák ⁶; L. Bláhová ⁷
Authors‘ workplace: Oční oddělení, Oblastní nemocnice Kolín ¹; LF OU, Ostrava ²; LF MU, Brno ³; Oční klinika LF OU a FN Ostrava ⁴; Dětská oční klinika LF MU a FN Brno ⁵; Katedra kybernetiky, Fakulta elektrotechnická, ČVUT v Praze ⁶; Neurologické oddělení, Oblastní nemocnice Kolín ⁷
Published in: Cesk Slov Neurol N 2015; 78/111(2): 181-187
Category: Original Paper

Overview

Aim:
To evaluate efficacy of pleoptic and orthoptic therapy combined with a home rehabilitation program with a support of a specifically‑ developed software in patients with ocular motility disorder and diplopia.

Methods:
Our study involved 86 adult patients with ocular motility disorder and diplopia (33 with rehabilitation – a study group, 53 without any rehabilitation – a control group). The causes of ocular motility disorders included cerebrovascular accident, craniocerebral trauma and vascular disease. A comprehensive ophthalmological and orthoptic examination were performed in all patients. The Hess‑ Lancaster screen tests were performed to objectify ocular motility disorder with diplopia. Follow‑up period ranged between 3 and 6 months in both groups.

Results:
The mean improvement of horizontal deviation in patients with the sixth cranial nerve palsy on one eye was 96.8% in the study group (p ≤ 0.01) and 28.2% in the control group (p ≤ 0.00001), and it was 73.7% in the study group (p ≤ 0.0008), 36.3% in the control group (p ≤ 0.05) in patients with the third and fourth cranial nerve palsy on one eye. The mean improvement of vertical deviation was 43.5% in the study group (p ≤ 0.002), 19.9% in the control group (p ≤ 0.04).

Conclusion:
This study demonstrates greater improvement of deviation and ocular motility deficit in adult patients who underwent the pleoptic and orthoptic therapy combined with a home rehabilitation program.

Key words:
paralytic strabismus – diplopia – conservative treatment – rehabilitation

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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