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Efektywność optometrycznej terapii wzroku w akomodacyjnej ezotropii z wysokim AC/A

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Przekoracka-Krawczyk A., Wojtczak-Kwaśniewska M.

OphthaTherapy

2018

vol. 5

issue 3

201-205

Convergence excess esotropia is commonly treated with corrective glasses (plus lenses), which reduces the angle of deviation for a distance, but the near deviation is still observed. Two types of approach are used to manage convergence excess esotropia: bifocals or eye muscles surgery. Nevertheless, both treatments seem to fail to influence the stereovision. The paper describes the case of 10-year-old girl, diagnosed with convergence excess esotropia with high AC/A ratio, who was subjected to the optometric vision therapy and bifocals. As an effect, visual parameters were improved, and majority of visual symptoms decreased. This case indicates that treatment plan for esotropia should include improvement of accommodation, eye movements and inter-ocular suppression, what strongly influence oculo-motor control and stereovision.

Akomodacyjna ezotropia z nadmierną konwergencją jest stanem, w którym korekcja nadwzroczności redukuje kąt zeza do dali, natomiast w bliży oczy pozostają ustawione w zezie zbieżnym. Wśród metod korekcji zeza tego typu można wyróżnić zastosowanie okularów dwuogniskowych oraz zabieg chirurgiczny na mięśniach okoruchowych. Jednak skuteczność obu tych podejść w uzyskaniu widzenia stereoskopowego pozostaje wątpliwa. Niniejsza praca opisuje przypadek 10-letniej pacjentki z akomodacyjną ezotropią z wysokim ułamkiem AC/A, u której zastosowana optometryczna terapia wzroku wspomagana korekcją dwuogniskową znacząco poprawiła funkcję widzenia oraz zredukowała symptomy wzrokowe. Przypadek ten pokazuje, że w postępowaniu ze stanami zezowymi bardzo istotne jest wyprowadzenie zaburzeń akomodacyjnych i okoruchowych oraz tłumienia międzyocznego, co pozwala na uzyskanie lepszej kontroli okulomotorycznej i widzenia stereoskopowego.

Stereopsis deficiency treatment using virtual reality games in exotropic candidate for firefighter

100%

Maciaszek D., Wojtczak-Kwaśniewska M.

OphthaTherapy

2021

vol. 8

issue 1

38-43

Background: Impaired stereopsis very often limits career options for patients with binocular vision disorders. Eyesight requirements for some occupations like police officers and firefighters usually include perfect visual acuity. In Poland, candidates for these professions must also demonstrate perfect stereopsis. The presented case study aims to demonstrate that vision therapy (VT1) mixed with new technologies may be an effective treatment for young adults who do not meet the chosen occupation's visual requirements. Case report: A case of a young man diagnosed with intermittent exotropia and poor stereopsis is discussed. Poor stereopsis did not allow him to pass the ophthalmological qualification tests to the fire academy. Vision therapy was implemented to improve stereopsis. The case report presents the patient’s treatment implemented within 4 years. The patient started with prismatic correction, then received the office-based VT with home reinforcement. The improvement in fusional vergence and the control of deviation was observed. Nevertheless, the patient was still stereo-deficient. 3 years later, Binocular Vision Therapy in Virtual Reality (BVTVR2) was recommended. The patient received home-based therapy for 16 weeks (60 minutes per day), which has resulted in significant improvement of stereopsis. As a result, he finally met the visual requirements to become a firefighter. Conclusion: BVTVR appears to be a promising rehabilitation method for patients with poor stereopsis. Three-dimensional anti-suppression therapy and dynamic, real-life stereopsis training seem to be a more effective treatment of poor stereopsis compared to standard VT techniques.

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2 OphthaTherapy

1 2021

1 2018

2 Wojtczak-Kwaśniewska M.

1 Maciaszek D.

1 Przekoracka-Krawczyk A.

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Efektywność optometrycznej terapii wzroku w akomodacyjnej ezotropii z wysokim AC/A

Stereopsis deficiency treatment using virtual reality games in exotropic candidate for firefighter