Dataset Information

Prevalence of Sagging Eye Syndrome in Adults with Binocular Diplopia.

ABSTRACT:

Purpose

Sagging eye syndrome (SES), horizontal and/or vertical strabismus caused by orbital connective tissue degeneration, was first defined 10 years ago. This study investigated SES and other causes of acquired binocular diplopia in adults presenting to a single institution since the description of SES.

Design

Retrospective observational case series.

Methods

Medical records were reviewed of all new patients over the age of 40 who presented to the Stein Eye Institute with binocular diplopia between January 2015 and December 2018. Clinical causes of diplopia were tabulated in patients grouped by age and sex. In patients with SES, we tabulated binocular alignment, types of treatment, and surgical outcomes.

Results

There were 945 patients of mean age 66.5 years, of whom 514 (54.4%) were female. The most common cause of diplopia was SES (31.4%). The 297 patients with SES were older at 71.2 years (P < 0.0001) and more predominantly female at 59.9% than other patients (52.0%; P = 0.023). The relative proportion of SES patients among all diplopic patients increased with age from 4.7% under age 50 years to 60.9% over the age of 90. Age-related distance esotropia was present in 35% and cyclovertical strabismus in 65% of cases of SES. Strabismus surgery was performed in 50% of cases of SES. Mean esotropia at distance decreased from 6.9 ± 0.7? preoperatively to 0.3 ± 0.3? postoperatively. Preoperative hypertropia decreased from 3.0 ± 0.3? to 0.7 ± 0.2? postoperatively. Surgery resolved diplopia in all cases.

Conclusions

It is important to recognize that SES is a very common cause of adult binocular diplopia.

SUBMITTER: Goseki T

PROVIDER: S-EPMC6911643 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Publications

Prevalence of Sagging Eye Syndrome in Adults with Binocular Diplopia.

Goseki Toshiaki T Suh Soh Youn SY Robbins Laura L Pineles Stacy L SL Velez Federico G FG Demer Joseph L JL

American journal of ophthalmology 20190914

<h4>Purpose</h4>Sagging eye syndrome (SES), horizontal and/or vertical strabismus caused by orbital connective tissue degeneration, was first defined 10 years ago. This study investigated SES and other causes of acquired binocular diplopia in adults presenting to a single institution since the description of SES.<h4>Design</h4>Retrospective observational case series.<h4>Methods</h4>Medical records were reviewed of all new patients over the age of 40 who presented to the Stein Eye Institute with ...[more]

PMID: 31526795

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Project description:Purpose(1) To devise a model-based method for estimating the probabilities of binocular fusion, interocular suppression and diplopia from psychophysical judgements, (2) To map out the way fusion, suppression and diplopia vary with binocular disparity and blur of single edges shown to each eye, (3) To compare the binocular interactions found for edges of the same vs opposite contrast polarity.MethodsTest images were single, horizontal, Gaussian-blurred edges, with blur B = 1-32 min arc, and vertical disparity 0-8.B, shown for 200 ms. In the main experiment, observers reported whether they saw one central edge, one offset edge, or two edges. We argue that the relation between these three response categories and the three perceptual states (fusion, suppression, diplopia) is indirect and likely to be distorted by positional noise and criterion effects, and so we developed a descriptive, probabilistic model to estimate both the perceptual states and the noise/criterion parameters from the data.Results(1) Using simulated data, we validated the model-based method by showing that it recovered fairly accurately the disparity ranges for fusion and suppression, (2) The disparity range for fusion (Panum's limit) increased greatly with blur, in line with previous studies. The disparity range for suppression was similar to the fusion limit at large blurs, but two or three times the fusion limit at small blurs. This meant that diplopia was much more prevalent at larger blurs, (3) Diplopia was much more frequent when the two edges had opposite contrast polarity. A formal comparison of models indicated that fusion occurs for same, but not opposite, polarities. Probability of suppression was greater for unequal contrasts, and it was always the lower-contrast edge that was suppressed.ConclusionsOur model-based data analysis offers a useful tool for probing binocular fusion and suppression psychophysically. The disparity range for fusion increased with edge blur but fell short of complete scale-invariance. The disparity range for suppression also increased with blur but was not close to scale-invariance. Single vision occurs through fusion, but also beyond the fusion range, through suppression. Thus suppression can serve as a mechanism for extending single vision to larger disparities, but mainly for sharper edges where the fusion range is small (5-10 min arc). For large blurs the fusion range is so much larger that no such extension may be needed.

Dataset Information

Prevalence of Sagging Eye Syndrome in Adults with Binocular Diplopia.

Purpose

Design

Methods

Results

Conclusions

Publications

Prevalence of Sagging Eye Syndrome in Adults with Binocular Diplopia.

Similar Datasets

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