Monocular Partial/Sector Occlusion Therapy: A Procedure to Inhibit Diplopia in Thyroid-Associated Ophthalmopathy.

Background: A condition generally associated with hyperthyroidism, thyroid-associated ophthalmopathy may present with signs that vary from patient to patient. Diplopia is one of the most common and debilitating of manifestations, and it can be difficult to treat effectively. Case Report: An adult fe...

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Publicado en:Optometry & Visual Performance Vol. 10; no. 1; pp. 31 - 37
Autor principal: Routt, Lawrence A.
Formato: case study pictorial tables/charts Journal Article
Publicado: Optometric Extension Program Apr2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2022
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      place: Lutherville Timonium, Maryland
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        atl: Monocular Partial/Sector Occlusion Therapy: A Procedure to Inhibit Diplopia in Thyroid-Associated Ophthalmopathy.
      aug:
        au: Routt, Lawrence A.
        affil: Optometrist, Routt Eye Clinic
      sug:
        subj:
          Graves' Ophthalmopathy Therapy
          Diplopia Prevention and Control
          Eyeglasses
          Female
          Adult
          Hyperthyroidism Complications
          Treatment Outcomes
          Adult: 19-44 years
          Female
      ab: Background: A condition generally associated with hyperthyroidism, thyroid-associated ophthalmopathy may present with signs that vary from patient to patient. Diplopia is one of the most common and debilitating of manifestations, and it can be difficult to treat effectively. Case Report: An adult female presented with thyroid-associated ophthalmopathy, complaining of "bulging, dry, gritty" eyes (OS worse than OD) and double vision when looking to the extreme right or left. Two weeks of dry eye therapy OU was successful, but intermittent diplopia persisted. The patient indicated that the diplopia was "not bothersome." Eight weeks after the initial examination, the patient reported constant diplopia in primary gaze that threatened her ability to remain independent. Prism was of no benefit. Occlusion of a whole spectacle lens resolved the diplopia, but she felt unsafe driving. Thus, a procedure was devised to occlude only the precise sector of one spectacle lens as needed to inhibit the constant binocular diplopia. This allowed the use of the total effective visual field of both eyes in primary gaze, enabling the patient to drive safely and to remain independent. Conclusion: Diplopia in thyroid-associated ophthalmopathy often varies from intermittent to constant, with or without spontaneous resolution. If binocular diplopia is constant, and prism is determined to be of no benefit, monocular partial/sector occlusion of a spectacle lens may be a viable option for inhibiting the diplopia. This occlusion therapy is unique in allowing optimal use of the total effective visual field of both eyes, and it can be used temporarily or chronically as needed.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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