Contribution of a Real Depth Distance Stereoacuity Test to Clinical Management
Table 2
Patients who had a change in clinical management following introduction of FD2. Patients 68–73 had evidence of stereopsis using the FD2 but not with near tests, patients 20–22, stereopsis with the near tests but not FD2 and patients 48–61 evidence of stereopsis with both the FD2 and near tests, respectively. Patient 21 was excluded from further analysis as the change was due to retinal detachment. Summary of the change in management is included in the right-most column. Diagnosis is included where established. Where no specific diagnosis established, extraocular muscle deviation recorded. Prism dioptres (pd), intermittent heterotropia (T), esophoria (EP), esotropia (ET), hyper or hypotropia (HT), hyper or hypophoria (HP), base-out (BO), and base-in (BI) prism, lateral rectus (LR), superior rectus (SR), superior oblique (SO), medial rectus (MR), inferior rectus (IR), right (R) and left (L), underaction (u/a), thyroid eye disease (TED).
Patient
Symptom
Deviation
Diagnosis/lesion
FD2(sec)
Near(sec)
Change in management
Distance
Near
68
Diplopia on depression
3pd HP, cyclotorsion
4pd HT, 1 cyclotorsion
(L)IVn paresis
50 with prism
nil
Prism accepted over entire varifocal
69
Intermittent diplopia
3pd HT
2pd ET, 2pd HT
Bilateral IR u/a. Pineal germinoma
25 with prism
nil
Given weakest prism possible to achieve distance stereo.
70
Diplopia
10pd ET, 5pd HT
16pd ET, 6pd HT cyclotorsion
LR and (L) SR and (R) SO u/a
25 with prism
nil
BO prism achieved dist stereo, but not for near
71
Increasing diplopia on downgaze
12pd E(T)
8pd E(T), 14pd ET on downgaze
Bilat VIn paresis. Acoustic neuroma
50 with prism
nil
Increased BO prism for distance to achieve distance stereo.
72
Diplopia
7pd HT
7pd HT, 7pd XT cyclotorsion
(L) IVn paresis
30 with prism
nil
Vertical prism accepted for distance.
73
Reversal of diplopia at near with prism
4pd HT
2pd HT cyclotorsion
(R) SR, (L) SO u/a
50 with prism
nil
Vertical prism accepted only for distance.
20
Intermittent diplopia
10pd ET, 4pd H(T)
2pd EP
Bilateral VIn (L) SR u/a
nil with prism
120 with prism
No diplopia with reduced prism. FD2 negative with deviation corrected
21
Intermittent diplopia
8pd XP
25pd XP
Decompensated XP Retinal detachment
nil
240
FD2 positive previously. Referred to vitreo retinal team.
22
Intermittent diplopia
4pd EP(T)
2pd EP
TED. Proptosis
nil
55
Orbital decompression. FD2 positive previously.
48
Diplopia on depression
7pd HP
7pd H(T)
IR u/a
30
300 with prism
Prism only on reading segment
49
Intermittent diplopia
6pd E(T)
2pd EP
(L)VIn
50 with prism
150
Prism over distance segment
50
Intermittent diplopia
2pd H(T)
10pd XP
TED
30 with prism
85
Prism over distance segment
51
Asymptomatic
2–4 pd E(T)
6pd XP
(R)VIn
50 with prism
480
Binocular with prism over distance segment
52
Intermittent diplopia
8pd E(T)
4pd EP
Bilat VIn
50 with prism
60
Increased prism to achieve distance stereoacuity
53
Resolving diplopia
6pd EP
2pd EP
(L)VIn resolving
15
55
Binocular without prism
54
Intermittent diplopia for near objects
12pd XP
35pd X(T)
Decompensating XP
50 without prism
600 with 10pd BI prism
Prism removed from distance segment
55
Blurred vision.
0 with spectacles
4pd XP to variable ET
Intermittent accommodative spasm
15 with spectacles
60
Accepted spectacles to achieve binocularity.
56
Intermittent diplopia for distant objects
2–4pd HT
2pd HP
(R) SR u/a
15 with prism
60
Binocular only with prism
57
Diplopia (monocular and binocular)
2pd EP
6pd X(T)
MR u/a Polyopia/correctopia
15 with and without prism
110
Removed prism for distance
58
Diplopia at near
XP
X(T)
Decompensating XP
40
1980 without, 85 with prism
Separate reading glasses with prism incorporated
59
Intermittent diplopia
ET
EP
Bilateral VIn
50 with prism
120
Not aware of diplopia but binocular only with prism