Exophoria

Introduction to the external oblique Exophoria is the tendency of the eye to have an outward deflection. It can be controlled by corrective fusion reflex, so that there is no deflection and can maintain binocular monocular. Generally, the external oblique obliqueness can exceed 5 . But depending on the patient's fusion function, if someone looks near 10 faint oblique, because the fusion convergence is good, it can be asymptomatic. On the contrary, some people see the near-outer oblique 4, which is a normal range, but the fusion Poor convergence, but visual fatigue. The main symptom of the disease is that forehead pain, sore eyes, unsustainable reading, unclear vision, serial, overlap, diplopia, etc., must be closed for a while before continuing to read, but soon again The above symptoms, severe cases can not continue to learn and work, clinically, sometimes a series of examinations according to refractive error, glaucoma or neurasthenia, wearing corrective glasses, but the symptoms have not been lifted. basic knowledge The proportion of illness: 0.3% Susceptible people: no special people Mode of infection: non-infectious Complications: blepharitis

Cause of external oblique

Body factor (35%)

The coordination of the extraocular muscles is disrupted by a weak, overexcited or neuromuscular disorder to produce a neurological stealth. It belongs to the external rectus muscle or the attachment point, the inner rectus muscle is weak or the attachment point is backward, and the ligament of the ligament is abnormal.

Congenital factors (25%)

The congenital factor is due to the abnormal development of the body's congenital, resulting in abnormal local anatomy of the eye, so that the eye movement is prevented by structural factors, resulting in static slant.

Improper use of the eye (15%)

Due to improper use of the eyes, such as reading too close, watching TV computers for a long time, causing refractive abnormalities caused by dynamic imbalance of adjustment and set imbalance.

External oblique prevention

Prevention methods are different for children of different ages, but the key is to prevent children from seeing things that are close together.

1. Baby: Parents must not hang their favorite toys too close.

2, young children: because they can get toys, parents should always pay attention to avoid him watching toys at close range.

3, preschool children: should take them outdoor activities, and intentionally guide them to see things in the distance.

It is not conducive to prevent children from strabismus by installing lights in the cradle or turning the lights on at night.

Concealed oblique complications Complications

Patients with severe occlusion can develop blepharitis.

Visceral oblique symptoms common symptoms visual impairment visual field vision diplopia

Short-term work soon, forehead pain, sore eyes, reading can not last, blurred vision, serial, overlapping, double vision and other symptoms, you must close your eyes and rest for a while before continuing to read, but soon the above symptoms appear, serious can not Continue to study and work, clinically, sometimes a series of examinations according to refractive error, glaucoma or neurasthenia, wearing corrective glasses, but the symptoms have not been lifted.

External oblique inspection

(1) Cover-to-cover test: The single-eye cover-de-cover test can diagnose the skew controlled by the fusion mechanism when the eyes are open. However, if there is a slant, the cover will break the fusion and the eye will be deflected. After fully covering one eye and quickly removing the cover sheet, the examiner can determine whether the covered eye has deflected after the cover sheet and form a fusion motion when the cover is removed. Sometimes, no matter what the cover is, it will become oblique. Therefore, the cover test should be repeated after the cover-de-cover test. After covering one eye, the occultation is easy to change into slanting. It is a feature of weak fusion force and often insufficient fusion force. This examination has important clinical significance.

(2) Triple prism plus cover method: This method is an objective quantitative test method. Firstly, the direction of the deviation of the eye position is detected by the alternating covering method. If the angle is implicit, a prism with a bottom outward is placed in front of the covered eye. If the angle is oblique, the bottom of the prism is inward and oblique. Place it bottom down. When removing the cover, if the covered eye is still rotating, increase the prism power until the eye stops rotating. The prism power used is the number of hidden degrees. If there is vertical or horizontal skew, the horizontal position is corrected first, and the vertical position is corrected.

(3) Maddox rod method: This method is a qualitative inspection method. It is to make the shape of the two eyes different to eliminate the fusion. The Maddox rod is a special inspection lens with several side-by-side cylindrical lenses (glass rods) mounted in a lens frame that can be placed on the trial frame. According to the refractive principle of the lenticule, a light can be refracted into a strip of light by the Maddox rod, and the direction of the light is perpendicular to the arrangement of the glass rods. The method is to place the cylindrical lens of the Maddox rod in the vertical position of the axial position or the axial position horizontally before the patient's eye, and let the eyes of the patient jointly look at the light spot at 5 m or 33 cm to judge the hidden oblique property. When the measurement level is slanted, put the Maddox rod horizontally in front of the right eye, and let the patient's eyes look at the light bulb at the same time. If the vertical light and the light spot are coincident, it means there is no hidden slant, and if it is biased to one side, there is slanting. If the vertical light seen by the right eye is located to the left of the light spot seen by the left eye, and the cross-view double vision is formed, it is an oblique oblique. Otherwise, the vertical light is located on the right side of the light spot to form an ipsilateral double vision. Concealed. As will. When the Maddox rod is placed vertically in front of the right eye, it can be detected whether there is vertical slanting. Through the eyes of the vertical Maddox rod, the bulb is horizontally crossed. If the horizontal line is just across the center of the bulb, there is no vertical slanting. When the horizontal light seen by the eye is below the light spot seen by the left eye, it is hidden in the right eye or under the left eye; otherwise, if the horizontal light seen by the right eye is above the light spot seen by the left eye, it is right. Concealed under the eyes or hidden on the left eye.

(4) Maddox rod plus prism method: Maddox rod and prism test is a subjective quantitative test. The method is that the front Maddox rod is placed at the front, and the triangular prism is placed on the front side of the other eye. If the edge is oblique, the bottom of the prism is outward. If the angle is external, the bottom of the prism is inward, such as the upper oblique angle, and the other is placed at the bottom of the prism. If the lower angle is hidden, the other side should wear the bottom of the prism. When the vertical oblique angle is the same as wearing the prism (that is, the Maddox rod and the prism are placed in front of one eye), the direction of the bottom of the prism should be opposite. At the same time, look at the light source at 5m or 33cm, and increase the prism power in turn until the strip light coincides with the light spot. The prism power used at this time is the hidden slope number.

Diagnostic diagnosis of external oblique

Diagnosis can be made by an oblique oblique check. It is important to pay attention to the identification of paralytic strabismus, common strabismus, and congenital sternocleidomastoid muscle fibrosis.

Paralytic strabismus: a type of non-common strabismus. The strabismus caused by extraocular muscle paralysis is called paralytic strabismus. The oblique with eye movement disorder is regarded as non-common strabismus. Non-common strabismus is divided into two types: spastic strabismus and paralytic strabismus. Strabismus caused by primary muscle (nerve) spasm is extremely rare, and is only seen by chance in tetanus, neurosis, and the like. Therefore, most of the extraocular tendons encountered in clinical practice are recurrent, so non-common strabismus generally refers to paralytic strabismus.

Common strabismus: the oblique direction of the common strabismus is more common with horizontal deflection, simple vertical deviation is rare, and some can be combined with vertical deflection. If some patients with internal obliqueity have an upward slant when the eyeball is turned inside, this vertical deflection is not entirely due to extraocular muscle paralysis, but often because the inferior oblique muscle is thicker than the upper oblique muscle and the strength is too strong. During internal rotation, the strength of the inferior oblique muscle is stronger than that of the superior oblique muscle, resulting in the eyeball turning up.

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