Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028738 (nystagmus)
 7,431 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dissociated vertical deviation is a not uncommon strabismic syndrome characterized by upward deviation of an eye when occluded, with downward movement of the eye when occlusion is removed. Associated findings include latent nystagmus and horizontal strabismus. Duane's retraction syndrome is the clinical declaration of anomalous cranial nerve innervation characterized by a marked limitation or absence of abduction, variable limitation of adduction, narrowing of the palpebral fissure, and apparent globe retraction on attempted adduction. We report a patient with both dissociated vertical deviation and bilateral Duane's retraction syndrome, demonstrating that dissociated vertical deviation can occur with the anomalous neuroanatomic substrate present in Duane's retraction syndrome.
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PMID:Dissociated vertical deviation in a patient with Duane's retraction syndrome. 213 48

The occlusion of one eye may trigger two types of deviation: 1) Heterophorias: the occluded eye deviates towards a horizontal, vertical or torsional abnormal position of rest. Fusion keeps the eyes straight during binocular fixation. 2) Dissociated deviations, horizontal (DHD), vertical (DVD), torsional (DTD): they are found in infantile strabismus. The deviation without fixation is always smaller than the deviation of the occluded eye. The more typical cases are the ones where the position of rest without fixation is an orthoposition. Normal binocular vision is lacking. Most of the time, an alternant neutralisation is found: the occlusion deviation is not the return of the occluded eye to an abnormal position of rest. The deviation is caused by a disequilibrium of binocular retinal stimulations. Horizontal and vertical deviations are easy to study. It is not the case in dissociated torsional deviation (DTD) where the incyclotorsion does not exist when fixation is absent. An indirect proof of extorsion is given by the study of horizontal and vertical deviations determined in the cardinal position of gaze. Extorsion of the globus leeds always to abnormal actions of the recti. This give a typical synoptometer chart which is found in any extorsion whatever its origins: paralysis, alphabetic patterns or infantile strabismus. Dissociated extorsions are always associated with a bilateral elevation in the primary position. Dissociated deviations are found in infantile strabismus with the other dissociations phenomenon such as nystagmus, optokinetic nystagmus asymmetry, fixation in adduction preference (and incyclotorsion).
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PMID:[Vertical and tortional deviations in early strabismus]. 220 93

The presence of a DVD makes the ocular motility examination complicate but it is a valuable sign for the clinician as it is noticed essentially in infantile early onset strabismus with latent nystagmus. It is fundamental not to confuse it with an hyperaction of the inferior oblique. It requires a surgical treatment: a recession of superior recti.
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PMID:[Dissociated vertical divergence. Early strabismus. Nystagmus]. 220 94

Forty patients with infantile esotropia were treated by one ophthalmologist and followed up for 5 to 14 years. In all cases the initial surgery was performed by the age of 2 years, 4 months. The angle of deviation was reduced to within 10 prism diopters of orthotropia in 34 patients, and in 26 of them the reduction was maintained. However, only 6 of the 26 with a stable reduction showed evidence of binocular function by both troposcopic evaluation and the Wirt stereo test. Dissociated vertical divergence, nystagmus and amblyopia were much more common among the patients in whom fusion did not develop and may be the cause of this failure.
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PMID:Sensory results following treatment of infantile esotropia. 688 94

The previously reported nomenclature and clinical characteristics of dissociated vertical deviation have been recorded. The incidence and characteristics of DVD have been determined by evaluation of 1,000 consecutive strabismus or nystagmus patients, and with selected chart study carried out on the 111 DVD patients found in this series. Electro-oculographic studies of selected patients with DVD provided objective evidence of the speed and amplitude of the ocular movements in DVD. Bell phenomenon, strabismus sursoadductorius and the Bielschowsky phenomenon were recorded and compared to clinical findings of strabismus patients with DVD. The technique for the results of surgery for DVD were described. Dissociated vertical deviation was characterized as a component of the overall strabismus picture.
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PMID:Dissociated vertical deviation-a clinical and laboratory study. 702 Feb 16

The posterior fixation operation affords the ophthalmologist an additional procedure for the correction of DVD, nystagmus blockage syndrome and abnormal distance/near relationships associated with esodeviations. The authors report that 95% of the patients had improved their control of manifest DVD. The results of surgery for the nystagmus blockage syndrome and abnormal distance/near relationship patients remain inconclusive. The posterior fixation procedure, while technically difficult, may be performed safely by the experienced surgeon. Refinements of the surgical technique are described.
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PMID:Posterior fixation suture operation (fadenoperation). 705 55

Congenital esotropia develops in the first 4 months of life in an infant who lacks the inborn mechanism for motor fusion. It manifests as an esotropia which is not eliminated by correction of hyperopia and occurs in an otherwise neurologically normal infant. The earliest practical time for surgery is 4 months of age. The eye is anatomically suited for surgery at this age and also, this is the earliest age that congenital esotropia can be diagnosed with confidence. The best attainable result of treatment of congenital esotropia is subnormal binocular vision. This result is more likely to be attained if infants are aligned by 18 months of age. Satisfactory alignment is produced in 80% to 85% of infants in one procedure with an appropriate bimedial rectus recession. An array of motor defects including DVD, latent nystagmus, oblique dysfunction, and A- and V-pattern appear at varying times after successful alignment. These associated findings are commonly found with, but are not unique to, congenital esotropia. The onset and clinical picture of congenital esotropia is satisfactorily explained by a theory first suggested by Worth that the strabismus is caused by an inborn defect in the motor fusion mechanism and aggravated by esotropital factors as suggested by Chavasse. In contrast to congenital esotropia, all other strabismus can be thought of as occurring on a secondary basis in a person with the inborn capacity for motor fusion, but who failed to maintain it because of conatal insurmountable strabismus (congenital third nerve palsy), who lost it because of acquired (postnatal) strabismus, who uses a strategy such as head posture alteration to retain fusion under favorable circumstances (Duane syndrome), who has intermittent strabismus with part-time suppression (X(T)), or who is maintaining alignment with nonsurgical means (refractive esotropia). For the future, I believe that advances in the management of congenital esotropia will depend on a better understanding of etiology leading to design and use of innovative nonsurgical techniques to discourage convergence and stimulate bifoveal fusion.
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PMID:19th annual Frank Costenbader Lecture--the origins of congenital esotropia. 771 8

Dissociated vertical deviation (DVD), a vertical strabismus, is often associated with infantile esotropia, latent nystagmus and excyclo-torsion. DVD usually becomes apparent at about three years of age. The authors wished to determine whether DVD is a manifestation of an abnormal motor vergence system or is part of a visual system disorder. Vertical eye movements of six subjects with DVD, on cover-uncover and alternate cover tests, were studied using the magnetic search eye coil system. Asymmetry between the eyes' saccades were quantified during the DVD upward movement and during a trial of pure vertical saccades. In three subjects the vertical deviation increased to its full amount through a smooth vertical divergence movement, and in the other three patients through a combination of smooth and asymmetrical saccade-like movements. The latencies of the DVD, the peak velocity of the deviation movements, its time constant and the asymmetries in the saccades suggest that DVD represents an abnormal vertical vergence system.
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PMID:Dissociated vertical deviation (DVD): The saccadic and slow eye movements. 2131 45

Both see-saw nystagmus and dissociated vertical divergence are cyclovertical eye movements characterized by vertical disconjugation and torsional conjugation. See-saw nystagmus is known to occur with chiasmal disorders and bitemporal hemianopia. Dissociated vertical divergence is commonly encountered in the infantile strabismus syndrome. A hypothetical model is presented in which both conditions are explained. The basic organization of the oculomotor system is most likely monocular and synchronous eye movements may have developed by neuronal coupling of the symmetrical oculomotor structures. The vertical dissociation of both eye movement disorders is explained by insufficiently developed neuronal coupling between the superior colliculi. A functional differentiation between crossed and uncrossed retinal ganglion cells fibers is assumed to cause this diminished binocular coupling in the case of see-saw nystagmus. The interstitial nucleus of Cajal may well play a pivotal role in explaining the distinct torsional eye movements in both conditions.
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PMID:A neural model for cyclovertical eye movements and their disorders. 2210 22

Laboratory evidence suggests that the interruption of binocularity produced by early onset strabismus inhibits normal development of cortical inputs to the brainstem optokinetic pathway, producing an asymmetry in monocular optokinetic responses. It has been proposed that this optokinetic asymmetry can be useful in evaluating the presence of binocular vision. We studied 134 strabismic and 16 orthotopic patients to determine the clinical prevalence of asymmetric optokinetic responses. Cooperative children and adults were tested. For each subject, the observer made a judgment about the presence or absence of symmetry in the nasally directed versus temporally directed monocular optokinetic responses to motion of a hand-held drum.Clinical evidence of significantly greater nasally than temporally directed optokinetic responses was observed in 58% of esotropie patients who developed strabismus before the age of 6 months; in 22% of esotropie patients with onset between 6 and 12 months of age; in 9% of esotropie patients with onset between 12 and 24 months of age; and in only 5% of esotropie patients with onset of esotropia after the age of 24 months. No asymmetry was observed in any of the exotropic patients or in the hypertropic patient and was present in only 6% of orthotropic patients. Statistical analysis indicates that in this population the finding of monocular optokinetic asymmetry in an esotropie patient implies an 85% chance that the onset of esotropia occurred in the first 6 months of life. Quantitative electro-oculographic recording demonstrated that the clinical evaluation of optokinetic asymmetry can detect high degrees of asymmetry, but may miss subtle ones. Dissociated vertical deviation and latent nystagmus were not consistently associated with asymmetry of the monocular optokinetic responses.It may be concluded that clinically evident asymmetry of monocular optokinetic response is strong evidence for esotropia of early onset, while the absence of such asymmetry does not rule out early onset. Other manifestations of infantile esotropia, such as latent nystagmus and dissociated vertical deviation, are not invariably associated with optokinetic asymmetry.
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PMID:Optokinetic asynunetry in esotropia. 2488 Jan 74


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