Diagnosis and measurement of cyclodeviation.

Abstract

SUMMARY A simple, convenient, and accurate method of detecting and measuring even the smallest degree of cyclodeviation with the help of two special major amblyoscope slides is described. Routine use of these slides in the investigation of all paralytic squints to detect and measure cyclodeviation is suggested. This will prove useful in the correct diagnosis and in the adequate management of a case of cyclovertical muscle palsy.The importance of the detection and measurement of cyclodeviation in all cases of paralytic squint is being increasingly realised, but it has not yet been a routine practice with all orthoptists and strabismologists because of the absence of a handy and at the same time accurate method of testing. Of the various methods commonly employed to detect cyclodeviation the Maddox double prism test and the Bielschowsky apparatus cannot measure it. The Maddox wing measures cyclodeviation only for near vision. The Maddox rod placed in a trial frame is often used to measure the defect at different distances and in different gaze positions, but a slight tilt of the frame or a slight malpositioning of the rod in the frame affects the measurement. We have also found the trial frame limits the extent of excursion of the eyes from primary to other gaze positions and thereby limits the usefulness of the method in cases of mild paresis of a cyclovertical muscle. Moreover, in this method the extent of excursion of the eyes from the primary positions cannot be measured, and therefore identical testing condition cannot be provided in subsequent followups, which is essential for comparing the findings in order to assess progress.The after-image method as described by Sood and Sen (1970) is useful, but some patients find it difficult to appreciate the tilt of the after-image, especially when it is slight. This method is also less convenient for measuring the deviation in the 9 cardinal positions of gaze, as the after-image often does not last long enough and has to be produced several times. Since a major amblyoscope is used in most orthoptic centres to measure horizontal and vertical deviation, it is quite convenient to measure

Cutaneous and Ocular Tuberculosis: A Review

“…Reports of large series of cases from Western Europe became rare once social recovery from World War II had been achieved but, as mentioned before, tuberculosis is more common in Eastern Europe, and reports of ocular involvement still appear in appreciable numbers (Bakholdina et al 1983). As would be expected from current British experience, the most impressive reports of ocular disease come from India (Sen 1977, Agrawal et al 1977, Sen 1980). In the United States the disease is rare and seen mainly in malnourished immigrants (Lowder & Char 1984).…”

A Novel Method for Evaluation of Ocular Torsion Angle by Optical Coherence Tomography

“…Cyclodeviation accompanies vertical strabismus in patients with trochlear nerve palsy, skew deviation, and Graves' orbitopathy. [1][2][3][4][5][6][7] Clinical assessment of subjective and anatomic torsion is an important adjunct for the diagnosis and treatment of cyclovertical strabismus. Commonly used methods for assessment of torsion include measurement of the ocular torsion angle for objective torsion [8][9][10] and synoptophore assessment for measurement of subjective torsion.…”