Changes of Deviation After the Patch and +3.00 Diopter Spherical Lens Test in Basic Intermittent Exotropia

Hyun-Chul Jin; Ji-Hyun Park; Se-Youp Lee

doi:10.3341/jkos.2010.51.12.1620

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Jin, Park, and Lee: Changes of Deviation After the Patch and +3.00 Diopter Spherical Lens Test in Basic Intermittent Exotropia

Original Article

J Korean Ophthalmol Soc 2010;51(12):1620-1624.

Published online: 7 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.12.1620

Changes of Deviation After the Patch and +3.00 Diopter Spherical Lens Test in Basic Intermittent Exotropia

Hyun-Chul Jin, MD¹, Ji-Hyun Park, MD², Se-Youp Lee, MD¹

¹Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea

²Department of Ophthalmology, Haeundae Paik Hospital, Inje University School of Medicine, Busan, Korea

Address reprint requests to Se-Youp Lee, MD Department of Ophthalmology, Keimyung University Dongsan Medical Center #194 Dongsan-dong, Jung-gu, Daegu 700-712, Korea Tel: 82-53-250-7720, 7707, Fax: 82-53-250-7705, E-mail: lsy3379@dsmc.or.kr

Received 13 February 2010 Accepted 3 November 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To assess the change of deviation angle after the patch test and +3.00 diopter (D) spherical lens test in basic intermittent exotropia.

Methods

The present study included 57 patients diagnosed with basic intermittent exotropia. The deviation angles at near and far before and after monocular occlusion of 40 minutes or more were measured. Afterward, change of deviation was also measured by placing +3.00 D spherical lenses at near.

Results

Results from the study revealed pre-occlusion mean deviation angles of 23.1 ± 7.41 prism diopters (PD) at near, and 23.9 ± 6.56 PD at far. After the patch test, the mean deviation angles were increased to 28.3 ± 6.50 PD (p < 0.0001) at near, and 25.5 ± 6.40 PD (p < 0.0001) at far. After the +3.00 D spherical lens test, the angle was increased to 31.5 ± 7.53 PD (p < 0.0001) at near. Using the gradient method, the average accommodation convergence – accommodation ratio was 1.4 ± 1.19 PD/D.

Conclusions

Both the patch test and +3.00 D spherical lens test significantly increased the deviation angles at near and far, they helped to find the maximum deviation angle in patients with basic intermittent exotropia.

Keywords: Basic intermittent exotropia, Monocular occlusion, +3.00 diopter spherical lens test

References

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Table 1.

Characteristics of study group

Number of patients	57
Male / Female	27 / 30
Age of patients (Mean ± SD^*, yr)	8.3 ± 2.32
Refractive error (Mean ± SD^*, diopters, OD^†/OS^‡)	−1.51 ± 1.85 / −1.48 ± 1.60

^* SD = standard deviation

^† OD = oculus dexter

^‡ OS = oculus sinister.

Table 2.

Mean deviation after occlusion and +3.00 D spherical lens test

Deviation angle (PD^*)	Near	Distance
Pre-occlusion	23.1 ± 7.41	23.9 ± 6.56
Post-occlusion	28.3 ± 6.50	25.5 ± 6.40
Post +3.00 D lens test	31.5 ± 7.53	

^* PD = prism diopters.

Table 3.

Comparison of mean angle increment in study group

Deviation angle (PD^*)	Near		Distance
Deviation angle (PD^*)	Responder^†	Non-responder^‡	Responder^†	Non-responder^‡
Post-occlusion	8.5 ± 4.05	0.8 ± 2.83	6.1 ± 1.76	0.8 ± 2.01
Post +3.00 D lens test	7.4 ± 2.62	0.8 ± 2.83	−0.1 ± 2.47	

^* PD = prism diopters

^† Responder = angle of deviation increased by 5 PD or more after monocular occlusion and +3.00 D spherical lens test

^‡ Non-responder = angle of deviation increased by 4 PD or less after monocular occlusion and +3.00 D spherical lens test.

Table 4.

Comparison of mean age in study group

Age (Mean ± SD^*, yr)	Near		Distance
Age (Mean ± SD^*, yr)	Responder^†	Non-responder^‡	Responder^†	Non-responder^‡
Post-occlusion	8.2 ± 2.11	8.4 ± 2.61	7.9 ± 2.47	8.4 ± 2.31
Post +3.00 D lens test	8.6 ± 2.47	8.0 ± 2.19		

^* SD = standard deviation

^† Responder = angle of deviation increased by 5 PD or more after monocular occlusion and +3.00 D spherical lens test

^‡ Non-responder = angle of deviation increased by 4 PD or less after monocular occlusion and +3.00 D spherical lens test.

Table 5.

Comparison of mean refractive error in study group

Refractive error (Mean ± SD^*, diopters, OD^†/OS^‡)	Near		Distance
Refractive error (Mean ± SD^*, diopters, OD^†/OS^‡)	Responder^§	Non-responder^Π	Responder^§	Non-responder^Π
Post-occlusion	−1.58 ± 1.94 /	−1.39 ± 1.74 /	−1.20 ± 1.66 /	−1.58 ± 1.91 /
Post-occlusion	−1.51 ± 1.61	−1.41 ± 1.63	−1.21 ± 1.91	−1.54 ± 1.55
Post +3.00 D lens test	−1.56 ± 1.77 /	−1.47 ± 1.95 /		
Post +3.00 D lens test	−1.56 ± 1.76	−1.41 ± 1.50		

^* SD = standard deviation

^† OD = oculus dexter

^‡ OS = oculus sinister

^§ Responder = angle of deviation increased by 5 PD or more after monocular occlusion and +3.00 D spherical lens test

^Π Non-responder = angle of deviation increased by 4 PD or less after monocular occlusion and +3.00 D spherical lens test.

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