[Conservative management of posttraumatic diplopia].

PURPOSE: To determine the effect of prism correction with physicotherapeutic procedures on symptomatic improvement in posttraumatic oculomotor, trochlear and abducent nerves palsy.

PATIENTS AND

METHODS

Twenty eight patients (five women and twenty three men) at the age range from 23 to 50 years (mean age of 36.5 y.o.) with the posttraumatic ophthalmic complications underwent routine ophthalmic and strabologic examination. Prism correction and vitaminum B1 in iontophoresis were used due to unilateral oculomotor, trochlear and abducent nerve palsy, at 3-11 (mean interval between the trauma and treatment commencement of 7 months) months after traffic accident. Additionally, oculomotor muscles motility training and orthoptic exercises were applied. The duration of therapy ranged from 11 to 18 months (mean treatment duration of 14.5 months).

RESULTS

All patients were considered cured at the end of treatment. We achieved the increased ocular range of motion (100%), the reduced horizontal and vertical deviation angle (75%), the extension of palpebral fissure (100%) and regression of diplopia (100%). The binocular vision in the free- and instrument-space environment evaluation improved after treatment (100% simultaneous perception, 100% fusion, 96,43% stereopsis) in 75% and 25% of patients without and with prism correction, respectively.

CONCLUSIONS

The use of prism correction led to regression of diplopia, ortophoria without compensatory head position and improved binocular vision function. Prism correction and physicotherapeutic procedures resulted in early improvement of ocular range of motion and accommodation.