By Bruce J. W. Evans BSc PhD FCOptom DipCLP DipOrth FAAO FBCLA, Sandip Doshi PhD MCOptom
* this article represents a standard method of the analysis and administration of binocular imaginative and prescient issues * it's a useful, very smooth textual content with a hugely designed structure and with huge use of complete color illustrations * Containing contributions by way of correct specialists within the box it truly is conscientiously edited to make sure that a uniform and constantly excessive ordinary is maintained all through
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Additional info for Binocular Vision & Orthoptics. Investigation and Management
6). This chapter examines the optometric investigation and management of these conditions. Reflex convergence Convergence is mainly a reflex activity, but can be initiated voluntarily. Reflex convergence is controlled by the occipital cortex and is considered to have four components: 1 2 3 Tonic convergence - the convergence brought about by the tonus in the extraocular muscles in an awake individual. With age, there is a decrease in tonus and therefore a tendency towards divergence. Proximal convergence - the convergence induced by an awareness of the nearness of the object.
At this stage, the patient will probably have voluntary convergence. • Step 4. The patient should practise obtaining three cats as above or by voluntary convergence using a card that is cut in half. The cards should then be separated horizontally, still maintaining three cats (rings). If the patient did not achieve voluntary convergence at step 3, he or she should now have attained it. Note: steps 3 and 4 are often given together. Ifthere is a need to alter or correct the refractive error, a short period of adaptation should be allowed before commencing exercises.
When the dot-on-the-line target is withdrawn from the near point of convergence and one eye loses fixation. The target will then be seen in uncrossed diplopia. Aetiology Convergence paralysis is associated with a lesion in the area of the third nerve nucleus or in the area of the corpora quadrigemina, and therefore occurs commonly Treatment Refer for an investigation of the cause. Prior to referral, a cycloplegic refraction is necessary to confirm the absence of an Convergence and convergent fusional reserves - investigation and treatment accommodative spasm due to latent hypermetropia.