Purpose: To evaluate the range of cyclodeviation in normal individuals by means of Cyclocheck® application recently designed by the authors and freely available at www.cyclocheck.com . Methods: Healthy subjects with normal muscle balance, best-corrected visual acuity of ⩾0.8, and stereopsis on Randot charts of ⩽100 s of arc were included in the study. Two separate digital fundus photographs were taken of each eye of every patient. The disk-foveal angle was calculated using the Cyclocheck® application. The average result of the disk-foveal angle measurements were considered for data analysis. Results: A total of 131 patients met inclusion criteria for the study population. The mean value of the disk-foveal angle in the whole study group (both right and left eye) was 6.39° ± 2.72° with 5.26° ± 2.56° (range from −0.4° to 12.55°) in the right eye and 7.52° ± 2.39° (range from 1.25° to 12.76°) in the left eye. The mean value of the disk-foveal angle of the left eye was greater by 2.26° than that of the right eye. Conclusion: Cyclocheck® software allows easy assessment of cyclodeviation. Normal individuals present with a positive value of the disk-foveal angle with a certain spread of the results. The analysis of obtained measurements revealed a significant asymmetry between both eyes with the left eye being more excyclodeviated in an otherwise orthotropic population, which remains a subject for further investigations.
Purpose To present and examine the results of surgical correction of simultaneous ocular elevation and depression deficit in patients who underwent reconstruction surgery for orbital floor fracture. Methods A retrospective analysis of medical records of patients who had undergone surgical correction for diplopia associated with orbital fracture which persisted after orbital reconstruction surgery. All patients underwent orthoptic evaluation before surgery and postoperatively with various times of follow-up. Results Eight cases of blow-out fracture of the orbital floor were identified. Surgical plan varied from case to case. It included thorough revision of inferior rectus/oblique complex with or without recession of the former or flap tear repair and additional procedures. Postoperatively 4 patients (50%) were diplopia free, 3 (37.5%) presented diplopia in extreme upgaze and 1 (12.5%) in mid-upgaze and adduction. None of the patients reported diplopia in the primary position neither downgaze. Conclusion Diplopia persisting after reconstructive surgery of a fractured orbital floor may be corrected surgically. Our results suggest that at least two surgical procedures are necessary to achieve satisfying outcomes. Contralateral inferior rectus recession combined with superior oblique recession and superior rectus posterior fixation appears to be effective procedures for use.
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