Year : 1983 | Volume
: 31 | Issue : 4 | Page : 367--368
Accomodation synoptophore in the treatment of convergence insufficiency
R Hanumanth Reddy, Vidyavati, Asha Divakaran
Sarojini Devi Eye Hospital and Institute of Ophthabnology, Hyderabad, India
R Hanumanth Reddy
Sarojini Devi Eye Hospital and Institute of Ophthalmology, Hyderabad, (A.P.)
|How to cite this article:|
Reddy R H, Vidyavati, Divakaran A. Accomodation synoptophore in the treatment of convergence insufficiency.Indian J Ophthalmol 1983;31:367-368
|How to cite this URL:|
Reddy R H, Vidyavati, Divakaran A. Accomodation synoptophore in the treatment of convergence insufficiency. Indian J Ophthalmol [serial online] 1983 [cited 2020 Apr 3 ];31:367-368
Available from: http://www.ijo.in/text.asp?1983/31/4/367/27556
Convergence and accomodation are -sub loosely linked. Still, physiologically, in the young, convergence function is always associated with a capacity to accommodate. Consequently any binocular training to be successful, must necessarily involve the simulation of the physiological conditions viz., close focusing. This is even more important in a patient with an abnormal accomodation and convergence relationship, as in convergence insufficiency. A person using a binocular device i.e., a common synoptophore, gets tired if he is forced to converge at a short distance while accomodating for infinity. Conversely, the new AS-1, designed after Bangerter, meets the fundamental requirement and provides a continuously adjustable accomodation demand along with the physiologically normal enlargement of the image. We have studied the use of this instrument in the treatment of convergence insufficiency and are presenting the results of the same.
MATERIALS AND METHODS
The instrument used is the new AS-1, designed after Bangerter. It is so designed optically as to give, in addition to the facilities of a normal synoptophore, the ability to make a continuously adjustable accomodation demand ranging from 0-10 D. This is: effected by using the pedal switches, and the accomodation can be read off a scale on the left arm of the instrument. The instrument is provided with Recco discs that make rapid picture changing possible. There are 8 slides, 2 for small children, 2 for school going children, 2 for. adolescents and. 2 for adults. They are of varying degrees and provide less contrast and more contrast pictures especially selected to make the training interesting and instructive to the various age groups. There are a series of them for the simultaneous perception and fusion and, fusion and stereopsis testing.
Twenty four patients were studied on a double blind basis. Patients selected were those who had symptoms but did not manifest tropia, and whose fusion width was less than 10° on the normal synoptophore. 12 out of these were treated on the normal synoptophore while the others were given exercises using the AS-l. All these patients were given biweekly sessions of treatment for 4 weeks. On the accomodation synoptophore, the exercises were given to the patient by presenting the object to the patient's eyes at a continuously adjustable distance and size, matching the angle of convercence at any given moment [Figure 1][Figure 2]
Analysis of results showed that the 12 cases treated on the AS-1 developed a better fusion width than those put on the N.S. [Figure 1][Figure 2]. There was an average of 40" increase with normal synoptophore and about 80% increase with the AS--1.
In treating a convergence insufficiency, if physiological conditions are simulated, the convergence impulse is much larger than when a common synoptophore is used. The patients showed a remarkably superior improvement in their fusion width.
|1||Bangerter A. 1975, Concilium Europaeum Strabismi Studio Deditum and the Swiss Strabology Congress.|