The Analysis of Ocular Deviations between Dominant and Non-dominant Eye Using Video-oculography in Intermittent Exotropia

Ji Hoon Ban; Sung Hyuk Moon

doi:10.3341/jkos.2019.60.7.685

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Ban and Moon: The Analysis of Ocular Deviations between Dominant and Non-dominant Eye Using Video-oculography in Intermittent Exotropia

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(7): 685-691.

Published online: 15 July 2019

DOI: https://doi.org/10.3341/jkos.2019.60.7.685

The Analysis of Ocular Deviations between Dominant and Non-dominant Eye Using Video-oculography in Intermittent Exotropia

Ji Hoon Ban, MD^1,², Sung Hyuk Moon, MD, PhD^1,²

¹Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

²T2B Infrastructure Center for Ocular Disease, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

Address reprint requests to Sung Hyuk Moon, MD, PhD. Department of Ophthalmology, Inje University Busan Paik Hospital, #75 Bokji-ro, Busanjin-gu, Busan 47392, Korea. Tel: 82-51-890-6016, Fax: 82-51-890-6329, koils79@naver.com

Received 13 February 2019 Revised 12 March 2019 Accepted 19 June 2019

The Korean Ophthalmological Society

(open-access):

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 measure and analyze ocular deviations between dominant and non-dominant eyes using video-oculography (VOG) in intermittent exotropia.

Methods

Fourteen subjects who were diagnosed with intermittent exotropia from July 2017 to July 2018 with age of 5 or more, visual acuity of 20/30 or better and corrected visual acuity of 20/25 or more and difference in vision of both eyes of 1 line or less on Snellen optotype were included. The subjects were asked to fixate on a black-on-white optotype at 1 m, which subtended a visual angle of 50 minutes of arc. The video files and data about ocular deviations were obtained using VOG with alternate cover test. We analyzed angles of ocular deviations in dominant and non-dominant eyes.

Results

Among the 14 subjects in this study, the mean age were 7.6 ± 1.7 (range 5–9 years). Seven of 14 subjects had the right eye dominance. Six of the 14 subjects were men. There was no significant difference of ocular deviations between the dominant and non-dominant eyes in VOG (p = 0.167). Additionally, there was no significant difference of the values of VOG when one eye was exodeviated or re-fixated (p = 0.244), when both eyes were deviated, and when both eyes were re-fixated (p = 0.195, 0.637).

Conclusions

In this study, there was no significant difference of ocular deviations between the dominant and non-dominant eyes, between when an eye was exodeviated or fixated using VOG. Therefore, it may not be a problem even if alternate prism cover test is performed in any eye in intermittent exotropia of more than 50 prism diopter without amblyopia or refraction abnormality that could affect the uncorrected visual acuity.

Keywords: Intermittent exotropia, Ocular deviations, Strabismus, Video-oculography

Figures and Tables

Figure 1

A video-oculography (VOG) (accuracy: 0.1 degree). (A) Two cameras installed at the top can make measurements of both eye movements (red arrowheads). A tilted semi-transparent glass allows subjects to fixate the target (red arrows). (B) The subjects wearing the VOG goggles were asked to fixate a target point between the two eyes and were instructed to keep the head straight so that the eyes were in primary position during the examination.

Figure 2

The graphs of video-oculography in the right-dominant eye. (A) is section of cover-uncover test in both eyes, (B) is section of alternative cover test. Initial binocular alignment was verified with both eyes open during the first 5 seconds. Subsequently, each eye was allowed 5 seconds of covered time and 5 seconds of uncovered time, and then the alternate cover test was repeated 3 times, with each eye being covered for 3 seconds.

Figure 3

The section of alternative cover test of a patient who has the right-dominant eye. (A) Differences of ocular deviations between the dominant and non-dominant eye at the same section. Six values (A–C) of the non-dominant eye with values of the dominant eye in the same section. We compared LA1 with RA1, LA2 with RA2, LB1 with RB1, LB2 with RB2, LC1 with RC1, and LC2 with RC2. (B) Differences in values when an eye is deviated or re-fixated. In the right eye, RA1 and RA2, RB1 and RB2, RC1 and RC2. In the left eye, LA1 and LA2, LB1 and LB2, LC1 and LC2. (C) Differences in values when the non-dominant eye is deviated and when the dominant eye is deviated. Applied when the non-dominant eye and the dominant eye are re-fixated. Re-fixation: RA2 and LA1, RB2 and LB1, RC2 and LC1, deviation: RA1 and LA2, RB1 and LB2, RC1 and LC2. ‘RA1’ is defined as the values of ‘A1’ section in the right eye.

Table 1

Baseline characteristics of subjects

Values are presented as mean ± standard deviation unless otherwise indicated.

OD = oculus dexter; OS = oculus sinister; D = diopter; PD = prism diopter; Sec = seconds of arc.

Table 2

Demographics and clinical characteristics of each participant

PD = prism diopter; D = diopter; sec = seconds of arc; M = man; OD = oculus dexter; OS = oculus sinister; W = woman.

Table 3

Comparison of ocular deviations between the dominant and non-dominant eyes

Values presented as mean ± standard deviation.

^*Paired t-test.

Table 4

Comparison of ocular deviations of an eye when the eye is deviated or re-fixated

Values presented as mean ± standard deviation.

^*Paired t-test.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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