AUDITORY BIOFEEDBACK TREATMENT OF DISSOCIATED VERTICAL DEVIATION.

Title AUDITORY BIOFEEDBACK TREATMENT OF DISSOCIATED VERTICAL DEVIATION.
Author, Co-Author Bruce Wick, Harold Bedell.
Topic
Year
1992
Day
Sunday
Program Number
Poster 45
Room
Great Hall
Affiliation
Abstract Dissociated vertical deviation (DVD), which is commonly seen in patients who developed esotropia in infancy, is a condition where the visual axis of an eye that is covered or suppressed rises above that of the non-covered eye. Although successful results are not routinely achieved, treatment has been attempted using vision therapy, prism correction, and/or strabismus surgery. Our 37 year old patient had a variable angle of strabismus, DVD, anomalous correspondence, horror fusionis, and amblyopia of the left eye. She developed esotropia at age 8 months after a bout with meningitis left her in a coma for one week. Strabismus surgeries at ages 3 and 11 resulted in a cosmetically acceptable eye position, but intractable constant diplopia had become increasingly bothersome (to the point where she has considered enucleation). Vision therapy was not successful in restoring binocularity, so an occluder contact lens was used to eliminate the diplopia. Unfortunately, her eye position then varied tremendously (as much as 25 [prism diopter sign] hypertropia with a horizontal angle that usually varied between ortho and 40[prism diopter sign] esotropia, but with occasional exotropia up to 30[prism diopter sign]). This cosmetically unacceptable variable strabismus was treated using auditory biofeedback to help the patient develop control of the DVD. Careful refraction minimized the horizontal deviation. Based on our successful treatment of this unusual patient, auditory biofeedback should be considered for general clinical use as a treatment for DVD. NEI R21 EY 00282 (BW); R01 EY 05068 (HEB)
Affiliation of Co-Authors
Outline