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Convergence insufficiency in idiopathic Parkinson's disease responsive to levodopa.

We report a patient with pathologically proven idiopathic Parkinson's disease (IPD) who developed diplopia secondary to convergence insufficiency during his motor "off" periods. Diplopia resolved with onset of motor benefit from levodopa. Neuro-ophthalmologic examination demonstrated convergence insufficiency during motor "off" periods that was alleviated after onset of motor benefit from levodopa. This is the first reported case of convergence insufficiency in IPD responsive to levodopa.

Disinsertion of the medial rectus following pterygium surgery: signs and management.

The clinical characteristics, intraoperative findings and management of two cases of "lost" medial recti during surgery for recurrent pterygium are described. The lost muscles are classified in different groups according to their etiopathogenesis. In the cases reported, the muscles were found retroinserted with extensive proliferation of fibrous tissue. This complication was resolved after finding the muscle, liberating the surrounding fibrous tissue and reattachment in its original insertion. Two aspects stand out: The CAT scan to determine the location of the muscle and the usefulness of top

Ophthalmoplegia in treated polymyalgia rheumatica and healed giant cell arteritis.

Diplopia may be a sign of giant cell arteritis (GCA). Polymyalgia rheumatica (PMR) is a systemic rheumatic inflammatory disease characterized by shoulder and hip girdle pain, and PMR can be associated in some patients with GCA. The authors report diplopia in two patients with treated PMR and biopsy-proven GCA, and review the literature on diplopia in GCA.

Sporadic Duane's Retraction Syndrome Associated with Imperforate Anus: Case Report.

Duane's retraction syndrome is sometimes associated with developmental ocular and extraocular abnormalities. This disorder may also be present in association with specific malformative syndromes. The authors report the clinical features of a seven-year-old female affected by Duane's retraction syndrome (D.R.S.), rectoperineal fistula, imperforate anus and other congenital malformations. From two extensive reviews of 106 reports published before 1982 and from a search (using Medline 1981-1994) for reports of congenital malformations associated with this syndrome, no cases of sporadic D.R.S. ass

Ocular Manifestations in Hematological Disorders.

Background Ophthalmic manifestations are a common feature in hematological malignancies and may be divided into two groups: those attributable to the disease's infiltration of the eye, and the ocular consequences due to blood abnormalities. This study aims to determine the prevalence of ocular manifestations and their association with the different hematological disease subgroups. Materials and methods We conducted a retrospective and observational study enrolling 137 consecutive patients on active treatment or follow-up for hematological malignancies from January 2016 to January 2020 at the C

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… spots | 1 | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - Roth spots | 14 | 6 | - | - | - | - | - | - | - | - | - | - | - | - | - | - CRVO | 4 | 1 | - | - | - | - | 2 | - | 2 | - | - | - | - | - | - | - Ocular adnexa | Ptosis | 1 | 1 | - | - | - | - | - | - | - | - | - | - | 2 | - | - | - Strabismus … Similarly, amongst our patients was one case of refractory acute lymphocytic leukemia (ALL) revealed by strabismus. Involvement of the central nervous system (CNS), namely cranial nerve palsy, is more prevalent in ALL patients than in AML patients [ 10 , 11 ]. …

The relationship between binocular vision components and visual evoked potentials with reading difficulties in elementary school children.

PURPOSE: To assess the relationship between visual function and neural processing with reading/writing defects in elementary school children. METHODS: This case-control study included 28 boys (8-12 years old) with poor academic performance (study group) and 14 healthy, age-matched controls. All participants underwent a comprehensive optometric evaluation, including visual acuity, refractive error, heterophoria, accommodation and convergence facility, fusional reserves, and monocular Visual evoked potentials (VEPs) using 15- and 60-checkerboard patterns (ISCEV standards). RESULTS: No signific

Alternative therapies versus patching for childhood amblyopia: a modality-stratified meta-analysis.

PURPOSE: Patching remains the standard treatment for childhood amblyopia but is constrained by adherence and psychosocial burden, motivating pharmacologic, optical, and binocular/digital alternatives that differ fundamentally in mechanism. Rather than asking whether alternatives are, on average, equivalent to patching - a question prior syntheses have answered by pooling mechanistically dissimilar interventions - we asked a more clinically useful question: does efficacy depend on the type and generation of therapy? METHODS: A PROSPERO-registered systematic review and meta-analysis (PRISMA 202

Does refractive error type affect amblyopia recovery? Evidence from a sample of Moroccan children.

Purpose: To determine whether the type of refractive error influences visual acuity recovery in children with anisometropic amblyopia and to assess differences in treatment responsiveness across hyperopic, myopic, and astigmatic anisometropia. Methods: A prospective longitudinal interventional study was conducted on 54 children aged 3-9 years diagnosed with unilateral anisometropic amblyopia. Participants were classified into three groups based on refractive error: hyperopic anisometropic amblyopia (HAA, n = 17), myopic anisometropic amblyopia (MAA, n = 18), and astigmatic anisometropic amblyo

Preliminary application of virtual reality technology in binocular vision recovery of children with intermittent exotropia after surgery.

Purpose: To investigate the clinical effects ofvirtual reality (VR) technology in children with intermittent exotropia (IXT) after surgery and analyze the factorsinfluencing binocular vision recovery. Methods: In this retrospective study, 142 childrenwith IXT were divided into two groups according to whether they underwent VR training or conventional training after surgery. Controlgroup: 66 cases underwent conventional training (lens sequencing training, flipper training, polarized stereogram, andcheiroscope training). VR group: 76 patients underwent regular VR visualtraining. We evaluated pre

Latency in the improvement course of fusional ability during orthoptic training for intermittent exotropia: a retrospective observational case series.

Purpose: To clarify the existence and characteristics of the latency period in the improvement course of fusional ability in patients with intermittent exotropia (IXT) treated with orthoptic training, and to contribute to clinical decision-making regarding the optimal timing for training termination. Study design: Retrospective observational case series. Methods: Fusional ability was assessed in 13 patients with IXT using the ratio of absolute fusional range divided by ocular deviation (FR/D ratio) and graphed to analyze the shape of the improvement course. The latency period was defined as th

Outcomes of anterior nasal transposition in inferior oblique overaction grades +3 and +4: a randomized controlled trial.

BACKGROUND: The optimal surgical approach for high-grade inferior oblique muscle overaction (IOOA) remains controversial. Both anterior nasal transposition (ANT) and conventional anterior transposition (ATIO) are used to correct this condition. We aimed to compare the efficacy, postoperative stability, and safety of ANT with ATIO for the treatment of high-grade IOOA. METHODS: This is a randomized controlled trial on patients with high-grade (+3 or +4) IOOA who were randomly assigned to either the ANT or ATIO group. Primary outcomes included changes in vertical deviation and postoperative grad

Monocular and binocular vision function following patching alone versus combined patching and active vision therapy in non-strabismic refractive amblyopia.

PURPOSE: To evaluate binocular visual function in amblyopic patients who achieved optimal visual acuity following treatment with either conventional patching alone or combined patching and structured Active vision therapy (AVT). METHODS: This retrospective chart review included 67 patients with non strabismic refractive amblyopia (31 patching; 36 combined treatment) who achieved best-corrected visual acuity (BCVA) ≤0.17 logMAR in both eyes after treatment. The combined treatment consisted of patching with structured active vision therapy incorporating anti-suppression, accommodative, vergence

Isolated fourth cranial nerve palsy in a patient treated with pembrolizumab: a case report.

Introduction: Pembrolizumab is widely used in melanoma treatment and may rarely be associated with neuro-ophthalmic immune-related adverse events. Isolated ocular motor nerve palsies are exceptional. Methods: We report a 76-year-old man who presented with sudden vertical binocular diplopia six weeks after starting adjuvant pembrolizumab following resection of cutaneous melanoma. A comprehensive neurological, ophthalmological, laboratory, and neuroimaging assessment was performed. Results: Ocular motility examination revealed an isolated right superior oblique palsy. Brain and orbital MRI showe

Monotherapy or combination therapy for myopia control: a structured narrative comparison of 12-month axial elongation.

Purpose: To compare annual axial elongation in children treated with low-dose atropine (0.01%) combined with optical interventions versus higher-dose atropine (≥0.05%) monotherapy and to assess whether combination therapy provides a clinically meaningful advantage over single-agent pharmacologic treatment. Methods: We reviewed 62 clinical studies reporting 12-month axial elongation in 5769 children (median age 9.7 years, IQR 1.2) receiving myopia control interventions. Eligible studies included atropine monotherapy (0.01%, 0.05%, 0.5% and 1%) and combination therapies pairing 0.01% atropine wi

Prevalence of foveal hypoplasia in a young adult cohort and its associations with visual acuity and birth parameters.

PURPOSE: This study describes the prevalence of foveal hypoplasia, the under-development of the fovea of the eye, in a young healthy adult cohort, using spectral domain-optical coherence tomography (SD-OCT) imaging, and correlations with visual acuity and birth parameters. METHODS: Participants were recruited from the Generation 2 (Gen2) of the Raine Study. At 20 years of age, Gen2 participants were invited to attend an eye examination including visual acuity with logMAR chart, contrast sensitivity and SD-OCT imaging. Birth weight and gestational age data were recorded at birth and data were

Marcus Gunn jaw-winking ptosis and contralateral lid retraction: management with Müller muscle-conjunctival resection with tarsectomy.

PURPOSE: Marcus Gunn jaw-winking syndrome (MGJWS) is a rare congenital cranial dysinnervation disorder characterized by synkinetic eyelid elevation during jaw movement. Standard surgical management often involves levator excision with bilateral frontalis suspension, which abolishes levator function but carries morbidity and variable cosmetic outcomes. Posterior ptosis approaches such as Müller muscle-conjunctival resection (MMCR) are well established for phenylephrine-responsive ptosis, but their role in MGJWS remains unclear. METHODS: A 12-year-old male with congenital left upper eyelid ptos

Prism adaptation versus conventional orthoptic measurement for symptomatic esophoria: a retrospective study.

Purpose: Symptomatic esophoria (SE) is a latent esodeviation that progresses into a manifest esotropia, causing substantial discomfort such as diplopia, headaches, and asthenopia. Surgery for esophoria is prone to undercorrection, necessitating repeated interventions. Addition of preoperative prism adaptation testing (PAT) reveals significantly larger angles of deviation (AOD). The aim of this retrospective study was to compare rates of repeated surgical interventions in SE patients with or without PAT as a supplement to standard orthoptic evaluation. Methods: We reviewed records of patients w

Surgical dose-responses of bilateral medial rectus muscle recession in acute acquired comitant esotropia compared to infantile esotropia.

Objective: To determine the surgical dose-responses of the bilateral medial rectus recession in acute acquired comitant esotropia (AACE) compared to infantile esotropia. Design: Retrospective study. Methods: The medical records of patients diagnosed with AACE and infantile esotropia who underwent bilateral medial rectus muscle recession (BMRR) were reviewed. Patient characteristics, ocular examinations and surgical data were collected. A motor success was defined as horizontal deviation within 10 prism diopters (PD) of ortho, and a sensory success was defined as no diplopia at 6 months after t

A nasal approach to a superior oblique tuck in the management of longstanding superior oblique palsy.

INTRODUCTION: Superior oblique palsy (SOP) is the most common cyclovertical muscle palsy, often presenting with vertical misalignment, excyclorotation, and abnormal head posture. The superior oblique tuck (SOT) is a widely accepted treatment option, though carries risks such as iatrogenic Brown syndrome. While a temporal approach is conventionally used, this case presents an alternative nasal approach to the SOT in a patient who had already undergone a temporal SOT. METHODS: A 71-year-old female presented with persistent diplopia and a left head tilt. Examination revealed right hypertropia an

Long-term outcomes of botulinum toxin A for acute acquired comitant esotropia in children: a retrospective case series.

PURPOSE: To evaluate the long-term efficacy of botulinum toxin A (BoNT-A) in children with acute acquired comitant esotropia (AACE). METHODS: This retrospective study included pediatric patients treated with BoNT-A for AACE between January 2021 and September 2024. Deviation angles at near (40 cm) and distance (5 m) were recorded before treatment and at 1, 3, 6, 12 months, and final follow-up. Outcomes were categorized as successful (≤10 prism diopters [PD]), partially successful (11-20 PD), or unsuccessful ( >20 PD). RESULTS: Twenty patients (mean age 5 ± 1 years; 65% female) were included.