New Tests of Distance Stereoacuity and Their Role in Evaluating Intermittent Exotropia

Jonathan M Holmes, Eileen E. Birch, David A. Leske, Valeria L. Fu, Brian G. Mohney

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Purpose: Poor control of intermittent exotropia has been considered an indication for surgical intervention, and poor distance stereoacuity may be an indicator of poor control. Two new measures of distance stereoacuity, the Frisby-Davis Distance test (FD2) and Distance Randot test (DR), both of which have been validated in normal and strabismic subjects, were evaluated, and we compared stereoacuity with scores on a recently described control scale. Design: Prospective case series. Participants: Twenty-five consecutive patients with intermittent exotropia. Methods: Office-based control was graded at distance and near on a 0 to 5 scale, and distance control ranged from 1 (recovery in 1-5 seconds after monocular occlusion) to 4 (>50% spontaneously tropic). Stereoacuity was measured using the FD2 and DR at distance and the Preschool Randot and Frisby tests at near. Main Outcome Measure: Distance stereoacuity measured using the FD2 and DR. Results: Measurable distance stereoacuity thresholds in intermittent exotropia were poor with the DR and excellent with the FD2 (medians, nil and 40″; P<0.0001). Near stereoacuity was excellent with both the Preschool Randot and Frisby (medians, 60″ and 60″; P = 0.99). There was poor correlation between distance control score and either FD2 (rs = 0.1, P = 0.6) or DR (rs = 0.3, P = 0.2). Control scores correlated with magnitude of deviation at distance (rs = 0.5, P = 0.02) and near (rs = 0.5, P = 0.01). Conclusions: The real-world contour-based targets of the new distance FD2 appear to stimulate fusion in intermittent exotropia, even when distance control is poor. In contrast, the new Polaroid vectograph-based DR is very sensitive to disturbances of binocularity. Two new distance stereoacuity tests appear sensitive to opposite ends of the intermittent exotropia spectrum; FD2 performance deteriorates when the patient is constantly tropic, whereas DR performance deteriorates at the earliest stages of intermittency.

Original languageEnglish (US)
Pages (from-to)1215-1220
Number of pages6
JournalOphthalmology
Volume114
Issue number6
DOIs
StatePublished - Jun 2007

Fingerprint

Exotropia
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

New Tests of Distance Stereoacuity and Their Role in Evaluating Intermittent Exotropia. / Holmes, Jonathan M; Birch, Eileen E.; Leske, David A.; Fu, Valeria L.; Mohney, Brian G.

In: Ophthalmology, Vol. 114, No. 6, 06.2007, p. 1215-1220.

Research output: Contribution to journalArticle

Holmes, Jonathan M ; Birch, Eileen E. ; Leske, David A. ; Fu, Valeria L. ; Mohney, Brian G. / New Tests of Distance Stereoacuity and Their Role in Evaluating Intermittent Exotropia. In: Ophthalmology. 2007 ; Vol. 114, No. 6. pp. 1215-1220.
@article{39aac0309a7544ccb4124a9e672473c8,
title = "New Tests of Distance Stereoacuity and Their Role in Evaluating Intermittent Exotropia",
abstract = "Purpose: Poor control of intermittent exotropia has been considered an indication for surgical intervention, and poor distance stereoacuity may be an indicator of poor control. Two new measures of distance stereoacuity, the Frisby-Davis Distance test (FD2) and Distance Randot test (DR), both of which have been validated in normal and strabismic subjects, were evaluated, and we compared stereoacuity with scores on a recently described control scale. Design: Prospective case series. Participants: Twenty-five consecutive patients with intermittent exotropia. Methods: Office-based control was graded at distance and near on a 0 to 5 scale, and distance control ranged from 1 (recovery in 1-5 seconds after monocular occlusion) to 4 (>50{\%} spontaneously tropic). Stereoacuity was measured using the FD2 and DR at distance and the Preschool Randot and Frisby tests at near. Main Outcome Measure: Distance stereoacuity measured using the FD2 and DR. Results: Measurable distance stereoacuity thresholds in intermittent exotropia were poor with the DR and excellent with the FD2 (medians, nil and 40″; P<0.0001). Near stereoacuity was excellent with both the Preschool Randot and Frisby (medians, 60″ and 60″; P = 0.99). There was poor correlation between distance control score and either FD2 (rs = 0.1, P = 0.6) or DR (rs = 0.3, P = 0.2). Control scores correlated with magnitude of deviation at distance (rs = 0.5, P = 0.02) and near (rs = 0.5, P = 0.01). Conclusions: The real-world contour-based targets of the new distance FD2 appear to stimulate fusion in intermittent exotropia, even when distance control is poor. In contrast, the new Polaroid vectograph-based DR is very sensitive to disturbances of binocularity. Two new distance stereoacuity tests appear sensitive to opposite ends of the intermittent exotropia spectrum; FD2 performance deteriorates when the patient is constantly tropic, whereas DR performance deteriorates at the earliest stages of intermittency.",
author = "Holmes, {Jonathan M} and Birch, {Eileen E.} and Leske, {David A.} and Fu, {Valeria L.} and Mohney, {Brian G.}",
year = "2007",
month = "6",
doi = "10.1016/j.ophtha.2006.06.066",
language = "English (US)",
volume = "114",
pages = "1215--1220",
journal = "Ophthalmology",
issn = "0161-6420",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - New Tests of Distance Stereoacuity and Their Role in Evaluating Intermittent Exotropia

AU - Holmes, Jonathan M

AU - Birch, Eileen E.

AU - Leske, David A.

AU - Fu, Valeria L.

AU - Mohney, Brian G.

PY - 2007/6

Y1 - 2007/6

N2 - Purpose: Poor control of intermittent exotropia has been considered an indication for surgical intervention, and poor distance stereoacuity may be an indicator of poor control. Two new measures of distance stereoacuity, the Frisby-Davis Distance test (FD2) and Distance Randot test (DR), both of which have been validated in normal and strabismic subjects, were evaluated, and we compared stereoacuity with scores on a recently described control scale. Design: Prospective case series. Participants: Twenty-five consecutive patients with intermittent exotropia. Methods: Office-based control was graded at distance and near on a 0 to 5 scale, and distance control ranged from 1 (recovery in 1-5 seconds after monocular occlusion) to 4 (>50% spontaneously tropic). Stereoacuity was measured using the FD2 and DR at distance and the Preschool Randot and Frisby tests at near. Main Outcome Measure: Distance stereoacuity measured using the FD2 and DR. Results: Measurable distance stereoacuity thresholds in intermittent exotropia were poor with the DR and excellent with the FD2 (medians, nil and 40″; P<0.0001). Near stereoacuity was excellent with both the Preschool Randot and Frisby (medians, 60″ and 60″; P = 0.99). There was poor correlation between distance control score and either FD2 (rs = 0.1, P = 0.6) or DR (rs = 0.3, P = 0.2). Control scores correlated with magnitude of deviation at distance (rs = 0.5, P = 0.02) and near (rs = 0.5, P = 0.01). Conclusions: The real-world contour-based targets of the new distance FD2 appear to stimulate fusion in intermittent exotropia, even when distance control is poor. In contrast, the new Polaroid vectograph-based DR is very sensitive to disturbances of binocularity. Two new distance stereoacuity tests appear sensitive to opposite ends of the intermittent exotropia spectrum; FD2 performance deteriorates when the patient is constantly tropic, whereas DR performance deteriorates at the earliest stages of intermittency.

AB - Purpose: Poor control of intermittent exotropia has been considered an indication for surgical intervention, and poor distance stereoacuity may be an indicator of poor control. Two new measures of distance stereoacuity, the Frisby-Davis Distance test (FD2) and Distance Randot test (DR), both of which have been validated in normal and strabismic subjects, were evaluated, and we compared stereoacuity with scores on a recently described control scale. Design: Prospective case series. Participants: Twenty-five consecutive patients with intermittent exotropia. Methods: Office-based control was graded at distance and near on a 0 to 5 scale, and distance control ranged from 1 (recovery in 1-5 seconds after monocular occlusion) to 4 (>50% spontaneously tropic). Stereoacuity was measured using the FD2 and DR at distance and the Preschool Randot and Frisby tests at near. Main Outcome Measure: Distance stereoacuity measured using the FD2 and DR. Results: Measurable distance stereoacuity thresholds in intermittent exotropia were poor with the DR and excellent with the FD2 (medians, nil and 40″; P<0.0001). Near stereoacuity was excellent with both the Preschool Randot and Frisby (medians, 60″ and 60″; P = 0.99). There was poor correlation between distance control score and either FD2 (rs = 0.1, P = 0.6) or DR (rs = 0.3, P = 0.2). Control scores correlated with magnitude of deviation at distance (rs = 0.5, P = 0.02) and near (rs = 0.5, P = 0.01). Conclusions: The real-world contour-based targets of the new distance FD2 appear to stimulate fusion in intermittent exotropia, even when distance control is poor. In contrast, the new Polaroid vectograph-based DR is very sensitive to disturbances of binocularity. Two new distance stereoacuity tests appear sensitive to opposite ends of the intermittent exotropia spectrum; FD2 performance deteriorates when the patient is constantly tropic, whereas DR performance deteriorates at the earliest stages of intermittency.

UR - http://www.scopus.com/inward/record.url?scp=34249731099&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34249731099&partnerID=8YFLogxK

U2 - 10.1016/j.ophtha.2006.06.066

DO - 10.1016/j.ophtha.2006.06.066

M3 - Article

VL - 114

SP - 1215

EP - 1220

JO - Ophthalmology

JF - Ophthalmology

SN - 0161-6420

IS - 6

ER -