The Effect of Conservative Therapy on Diplopia in Patients with Paralytic Strabismus

Authors: L. Pražáková 1;  J. Timkovič 2–4;  R. Autrata 3,5;  P. Rezek 1;  P. Novák 6;  L. Bláhová 7
Authors‘ workplace: Oční oddělení, Oblastní nemocnice Kolín 1;  LF OU, Ostrava 2;  LF MU, Brno 3;  Oční klinika LF OU a FN Ostrava 4;  Dětská oční klinika LF MU a FN Brno 5;  Katedra kybernetiky, Fakulta elektrotechnická, ČVUT v Praze 6;  Neurologické oddělení, Oblastní nemocnice Kolín 7
Published in: Cesk Slov Neurol N 2015; 78/111(2): 181-187
Category: Original Paper


To evaluate efficacy of pleoptic and orthoptic therapy combined with a home rehabilitation program with a support of a specifically‑ developed software in patients with ocular motility disorder and diplopia.

Our study involved 86 adult patients with ocular motility disorder and diplopia (33 with rehabilitation –  a study group, 53 without any rehabilitation –  a control group). The causes of ocular motility disorders included cerebrovascular accident, craniocerebral trauma and vascular disease. A comprehensive ophthalmological and orthoptic examination were performed in all patients. The Hess‑ Lancaster screen tests were performed to objectify ocular motility disorder with diplopia. Follow‑up period ranged between 3 and 6 months in both groups.

The mean improvement of horizontal deviation in patients with the sixth cranial nerve palsy on one eye was 96.8% in the study group (p ≤ 0.01) and 28.2% in the control group (p ≤ 0.00001), and it was 73.7% in the study group (p ≤ 0.0008), 36.3% in the control group (p ≤ 0.05) in patients with the third and fourth cranial nerve palsy on one eye. The mean improvement of vertical deviation was 43.5% in the study group (p ≤ 0.002), 19.9% in the control group (p ≤ 0.04).

This study demonstrates greater improvement of deviation and ocular motility deficit in adult patients who underwent the pleoptic and orthoptic therapy combined with a home rehabilitation program.

Key words:
paralytic strabismus – diplopia – conservative treatment – rehabilitation

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


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