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Kim, Lee, and Rah: Eye Fixation in Patients with Dissociated Vertical Diviation
Original Article

J Korean Ophthalmol Soc 2014;55(6):882-886.

Published online: 30 August 2014

DOI: https://doi.org/10.3341/jkos.2014.55.6.882

Eye Fixation in Patients with Dissociated Vertical Diviation

Ji Eob Kim, MD, Jong Hyuck Lee, MD, Sang Hoon Rah, MD

Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju, Korea

Address reprint requests to Sang Hoon Rah, MD, Department of Ophthalmology, Yonsei University Wonju Severance Christian Hospital, #20 Ilsan-ro, Wonju 220-701, Korea, Tel: 82-33-741-0631, Fax: 82-33-741-0114, E-mail: shrah@yonsei.ac.kr

Received 13 September 2013       Revised 4 March 2014       Accepted 23 May 2014

Copyright © The 2014 Korean Ophthalmological Society

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 clinically determine the proportion of people with a fixed dissociating eye in patients with dissociated vertical deviation (DVD).

Methods

Medical records of 86 patients diagnosed with DVD in our department of ophthalmology from 2001 to November 2011 were retrospectively analyzed.

Results

Of the 71 patients, 25 (35.21%) showed a higher degree of dissociation in the fixating eye, 26 (36.62%) had higher dis-sociation in the non-fixating eye; 20 of 25 patients with a higher level of dissociation in the fixating eye and 22 of 26 patients with a higher level of dissociation in the non-fixating eye received surgical correction for DVD, such as superior rectus muscle re-cession or inferior oblique muscle anterior transposition.

Conclusions

In DVD, the proportion of patients showing a higher level of dissociation in the fixating eye was significant. Patients with DVD require thorough evaluation; measurement of the level of dissociation and determination of the fixating eye is beneficial for management and surgical intervention.

Keywords: Dissociated vertical deviation (DVD), Fixating eye

References

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Table 1.
Superior rectus muscle recession according to deviation in dissociated vertical deviation
Vertical deviation (PD) Amount of recession (mm)
<10 5
10-14 6
15-19 7
20-25 8
>25 9

PD = prism diopters.

Table 2.
Deviation angle of DVD based on higher dissociating eye
DVD (PD) Number of patients (%)
<10 6 (8.4)
11-15 12 (16.9)
16-20 13 (18.3)
21-25 26 (36.6)
>25 5 (7.0)
Unknown 9 (12.7)

DVD = dissociated vertical deviation; PD = prism diopters.

Table 3.
Characteristics of study participants
Characteristics Value Range
Age (years) 14.9 ± 11.6 4-47
Sex
 Male 39
 Female 32
Fixating eye
 Right eye 27
 Left eye 24
 Unknown 20

Values are presented as mean ± SD.

Table 4.
Eye showing higher level of dissociation is fixating or non-fixating, in DVD patients
Higher degree of dissociation at Number Percentage (%)
Fixating eye 25 35.21
Non fixating eye 26 36.62
Unknown 20 28.17

DVD = dissociated vertical deviation.

Table 5.
Number of superior rectus muscle recession or inferior oblique muscle anterior transposition
Higher degree of dissociation at Number Patients with operation
 p-value
BSR BIOAT
Fixating eye 25 8 12 0.222
Non fixating eye 26 14 8

BSR = bilateral superior rectus muscle recession; BIOAT = bilateral inferior oblique muscle anterior transposition.

Table 6.
Associated ocular motor abnormalities of patients
Type of strabismus Total Number Number of higher degree of dissociation at fixating eye Number of higher degree of dissociation at non fixating eye
Exotropia 48 12 21
Esotropia 19 11 4
IOOA 34 14 10
SOOA 16 7 5
Right hypertropia 7 2 3
Left hypertropia 7 4 3
DHD 1 0 1

IOOA= inferior oblique muscle overaction; SOOA = superior oblique muscle overaction; DHD = dissociated horizontal deviation.

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