The Orthoptic Examination in Paretic Strabismus: What Special Tests Should You Always Do?

Abstract

An adequate orthoptic evaluation of a patient with paretic strabismus should provide the physician with documentation of the patient's symptoms and a careful assessment of his fusional potential. The latter is especially important if the possibility of a coexisting supranuclear disturbance of motor fusion is suspected. The binocular visual field measured with a perimeter can be a useful method of documenting the extent of loss of visual efficiency for compensation purposes. Ductions recorded on a perimeter are also useful in following the status of a muscle palsy. In addition, reproducible and consistent measurement of the deviation can be of value both as a diagnostic aid and as documentation for later reference.