High-Adherence Dichoptic Treatment Versus Patching in Anisometropic and Small Angle Strabismus Amblyopia: A Randomized Controlled Trial.

Purpose: To compare the effectiveness and safety of a novel binocular eye-tracking-based-home-treatment (CureSight) to patching for the treatment of amblyopia.

Design: Prospective, masked, multicenter randomized controlled trial.

Methods: One hundred forty-nine children 4 to < 9 years with anisometropic, small-angle strabismic, or mixed-mechanism amblyopia were randomized to either binocular dichoptic treatment (n=75) or patching (n=74).

Lateral Rectus Disabling and Simultaneous Modified Nishida Procedure for Exotropic Duane Retraction Syndrome.

Exotropic-Duane Syndrome (XT-DRS) is a congenital cranial nerve dysinnervation disorder characterized by exotropia, anomalous head posture (contralateral face turn), limited adduction, globe retraction, palpebral fissure narrowing, upshoot and downshoot in adduction, and varying levels of limitation of abduction. Patients with XT-DRS often have poor convergence because attempted convergence induces co-contraction of the lateral rectus muscle (LR) due to anomalous LR innervation. We describe two patients with XT-DRS who underwent simultaneous lateral rectus muscle (LR) disinsertion and periosteal fixation (LRDAPF) and modified Nishida procedure (MNP) and discuss their outcome.

Binocular Home Treatment for Amblyopia: Gains Stable for One Year.

Purpose: To report the long-term outcomes of a noninferiority randomized controlled trial (RCT) with a binocular eye-tracking-based home treatment (CureSight; NovaSight, Ltd.) in patients with amblyopia.

Design: Prospective, multicenter, nonrandomized, long-term follow-up observational study of an RCT.

Modified Nishida Procedure Combined with Lateral Rectus Disabling for Duane Retraction Syndrome.

Duane retraction syndrome (DRS) is a complex congenital cranial dysinnervation disorder. The choice of surgical procedure in esotropic-DRS depends upon several factors that include: the amount of esotropia in the primary position, the presence and severity of palpebral fissure narrowing, globe retraction, presence of medial rectus muscle (MR) contracture, the likelihood of improving abduction, age of the patient, and the presence of binocularity and stereopsis. In the presence of MR contracture, MR recession is performed either alone (unilaterally or bilaterally) or in conjunction with Y splitting plus recession of the lateral rectus muscle (LR) for reducing globe retraction.

An Eye-Tracking-Based Dichoptic Home Treatment for Amblyopia: A Multicenter Randomized Clinical Trial.

Purpose: Comparing visual outcomes after use of a novel binocular eye-tracking-based home treatment (CureSight; NovaSight, Ltd) with patching.

Design: Prospective, multicenter, randomized, masked, controlled, noninferiority pivotal trial.

Participants: One hundred three children 4 to < 9 years with anisometropic, small-angle strabismic or mixed-mechanism amblyopia were randomized 1:1 to either CureSight treatment or patching.

Forty-five Years of Studying Intermittent Exotropia - What Have I Learned? The WSPOS Keynote Strabismus Lecture, October 3, 2020.

There are three keys to understanding how the new way of classifying and treating intermittent exotropia (IXT) differs from Burian's classic classification. First, the assumption that lateral rectus surgery selectively affects the distance deviation, recess/resect procedures affect the distance and near equally, and that medial rectus surgery selectively affects the near deviation, are false assumptions. Second, AC/A ratios in IXT can be calculated in all the usual manners, provided that any near measurement used in the calculation be made after prolonged monocular occlusion to eliminate the contaminating effect of the Scobee phenomenon.

Eccentric Gaze as a Possible Cause of "Zoom Fatigue".

Background: The Covid-19 pandemic has led to a marked increase in the use of videoconferencing for social interaction. Many people report discomfort and disaffection with this modality, which has been labeled "Zoom Fatigue." Common videoconferencing hardware setups necessitate that if a user looks at the image of the person with whom they are in videoconference, they will not be looking directly at the camera and will appear to not be making direct eye contact.

Definition of successful outcomes after surgery for each type of strabismus: a Delphi study.

Background: The Delphi process has been widely used to delineate guidelines for the treatment of disorders for which there is little or no evidence in the published literature. The purpose of this study was to use the Delphi process to identify areas of consensus and disagreement on the definition of success after surgery for each type of strabismus.

Methods: Two rounds of electronic questionnaires were sent to 28 members of the Strabismus Success Definition Delphi Study Group.

Use of the Delphi process for defining successful outcomes for strabismus surgery.

The purpose of this review was to identify areas of consensus and disagreement among experts for the definition of success following strabismus surgery using the Delphi process. Three rounds of electronic questionnaires were sent to a panel of 28 strabismus experts. Throughout the process, members of the panel were masked to one another's identities to minimize the possibility of influence among members.

Conservative management of intermittent exotropia to defer or avoid surgery.

Background: Surgery for intermittent exotropia performed at a very young age has poorer sensory outcomes than surgery performed later; moreover, postoperative recurrence is common, regardless of age. Alternate occlusion decreases the size of the exotropia and improves control. The purpose of this study was to report the long-term effects of part-time alternate occlusion and overminus spectacles combined with prism on delaying or avoiding surgery in intermittent exotropia.

Long-Term Follow-Up of Cyclic Esotropia.

Background And Purpose: To describe the development and treatment of patients with cyclic esotropia.

Patients And Methods: The clinical course of seven patients with cyclic esotropia were retrospectively reviewed and described. All patients underwent bilateral medial rectus recession based on the deviation manifested on the day they were esotropic.

Re-Operation Strategies in Strabismus-Cooper's Dictum Amended.

Purpose: To outline a systematic approach to strabismus reoperations. Many strabismologists have a formulaic approach to strabismus reoperations, e.g.

The Functional Benefits of Strabismus Surgery.

When performed prior to visual maturity, strabismus surgery can result in the development or recovery of binocularity. When strabismus surgery is performed after visual maturity, the functional benefits of the surgery should be dichotomized according to whether the onset of the strabismus was before or after visual maturity. If the onset was after visual maturity, patients typically are diplopic.

Retinothalamic White Matter Abnormalities in Amblyopia.

Purpose: Amblyopia is associated with a broad array of perceptual and neural abnormalities in the visual system, particularly in untreated or unsuccessfully treated populations. Traditionally, it has been believed that the neural abnormalities are confined to the visual cortex and subcortex (e.g.

Tenacious Proximal Fusion: The Scobee Phenomenon.

Background And Purpose: When patients with intermittent exotropia show an increase in their near deviation after prolonged monocular occlusion, they have been said to have tenacious proximal fusion (TPF). That term is not adequately descriptive, since this finding can occur without the patient having been allowed to fuse. The purpose of this study is to investigate the possibility that this phenomenon is mediated by the preponderance of binasal retinal disparity and uncrossed localization that occurs with near fixation.

Eye muscle surgery for recurrent nystagmus related to head tilt after prior torsional surgery.

Purpose: To describe the usefulness of anterior nasal transposition of the inferior oblique muscle in the fixing eye to treat nystagmus-mediated head tilt recurring after prior torsional surgery.

Methods: The medical records of patients who underwent anterior nasal transposition of the inferior oblique muscle in the fixing eye to treat recurrence of head tilt after prior successful torsional surgery were retrospectively reviewed.

Results: Three patients met inclusion criteria.

Surgical treatment of teenagers with high AC/A ratios.

The surgical approach to esotropia with a high AC/A ratio in teenagers should be dichotomized based on whether or not there is satisfactory alignment at distance with the cycloplegic correction in place. If there is not, surgery should target the near angle with glasses on. If there is good alignment at distance, bifocals should be used, and surgery deferred until the patient is approximately 18 years of age.

The benefits, risks, and efficacy of strabismus surgery in adults.

Strabismus surgery in adults achieves satisfactory alignment with one operation in approximately 80% of patients, depending on the specific nature of the problem. Risks of adult strabismus surgery are relatively low, and serious complications are anecdotal and rare. Even if the strabismus has been long-standing, most adults will experience some improvement in binocular function after strabismus surgery.