Clinical Management of Binocular Vision: Heterophoric, Accommodative, and Eye Movement Disorders

732 Pages·2013·17.567 MB·English

by  Mitchell Scheiman OD, Bruce Wick OD PhD

C L I N I C A L M A N A G E M E N T O F
B i n o c u l a r V i s i o n
Heterophoric, Accommodative,
and Eye Movement Disorders
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C L I N I C A L M A N A G E M E N T O F
B i n o c u l a r V i s i o n
Heterophoric, Accommodative,
and Eye Movement Disorders
Fourth Edition
Mitchell Scheiman, O.D. Bruce Wick, O.D., Ph.D.
Professor Professor Emeritus
Associate Dean of Research University of Houston
Pennsylvania College of Optometry College of Optometry
at Salus University Houston, Texas
Elkins Park, Pennsylvania
Ilustrator
Barbara Steinman
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Third Edition © 2008 by Lippincott Williams & Wilkins
Second Edition © 2002 by Lippincott Williams & Wilkins
First Edition © 1994 by J.B. Lippincott Co
All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form
by any means, including photocopying, or utilized by any information storage and retrieval system without written
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Library of Congress Cataloging-in-Publication Data
Scheiman, Mitchell.
Clinical management of binocular vision : heterophoric, accommodative, and eye movement disorders / Mitchell Scheiman,
Bruce Wick. — 4th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4511-7525-7
I. Wick, Bruce. II. Title.
[DNLM: 1. Ocular Motility Disorders—therapy. 2. Accommodation, Ocular. 3. Vision Disparity. 4. Vision, Binocular.
WW 410]
RE735
617.7'62—dc23
2013015242
Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices.
However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from
application of the information in this book and make no warranty, expressed or implied, with respect to the currency,
completeness, or accuracy of the contents of the publication. Application of the information in a particular situation
remains the professional responsibility of the practitioner.
The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in
this text are in accordance with current recommendations and practice at the time of publication. However, in view of
ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy
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To Maxine, for her love, patience, and understanding.
—M.S.
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Preface
ver the past 19 years we have received very positive feedback from colleagues and students about
O
the first three editions of this book. They have remarked that this book is easy to read and under-
stand, and that it provides valuable information about the diagnosis and treatment of binocular
vision. We have also continued to receive excellent constructive criticism and suggestions and as in the past
we have tried to respond to these suggestions in this new edition.
In both editions 2 and 3, it was necessary to add new chapters to respond to reader suggestions. For this
edition, however, we have not added any new chapters. Rather, the main purpose of this new edition is to
refresh the book with the latest research and evidence supporting the evaluation and treatment protocols
suggested. Over the course of 5 years there have been new research studies and other new literature that are
relevant to the topics covered in this text. We have carefully reviewed this new literature and have incorpo-
rated information from these studies when appropriate.
One of the other important changes has been the introduction of new technology and equipment for vision
therapy. We have tried to include information about new vision therapy equipment in this new edition in
Chapters 6–8. Finally, all of the illustrations in the book have been updated and a majority of the illustrations
are now in color.
We hope that the updated material will make this fourth edition even more useful than the previous edi-
tions for faculty designing courses, students studying these topics for the first time, and established practi-
tioners looking for a practical, easy-to-use reference on accommodative, ocular motility, and non-strabismic
vision anomalies.
Mitchell Scheiman, O.D.
Bruce Wick, O.D., Ph.D.
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Acknowledgments
ne of the authors (M.S.) acknowledges individuals who have had a strong influence on his profes-
O
sional development and the field of binocular vision and vision therapy:
Dr. Jerome Rosner, who was so instrumental in teaching me how to teach in the very early stages
of my career and giving me the push I needed to get involved in didactic teaching; Drs. Nathan
Flax, Irwin Suchoff, Jack Richman, Martin Birnbaum, and Arnold Sherman, who inspired me to devote my
professional career to the areas of vision therapy, pediatrics, and binocular vision; all the investigators of the
Convergence Insufficiency Treatment Trial who have helped complete the first large-scale randomized clinical
trial of vision therapy for the treatment of convergence insufficiency.
Dr. Michael Gallaway, for his personal and professional support over the last 30 years, Dr. Barbara
Steinman, for her outstanding work in designing the illustrations for the second, third, and fourth editions of
this book; my family, for their support, and for showing so much patience with me during my many months
of writing.
I (B.W.) wish to acknowledge my father, Dr. Ralph Wick, for his assistance and support throughout
my career. In addition, thanks to Drs. Monroe Hirsch, Merideth Morgan, and Mert Flom, who all strongly
influenced my development in the field of binocular vision and vision therapy. Above all, thanks to my wife
Susan for everything.
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Contents
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vi
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii
I Diagnosis and General Treatment Approach
S E C T I O N
1 Diagnostic Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2 Case Analysis and Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
3 General Treatment Modalities, Guidelines, and Prognosis . . . . . . . . . . . . 89
4 Primary Care of Binocular Vision, Accommodative,
and Eye Movement Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
II Vision Therapy Procedures and Instrumentation
S E C T I O N
5 Introduction and General Concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
6 Fusional Vergence, Voluntary Convergence, and Antisuppression . . . . . 160
7 Accommodative Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
8 Ocular Motility Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
III Management
S E C T I O N
9 Low AC/A Conditions: Convergence Insufficiency
and Divergence Insufficiency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
10 High AC/A Conditions: Convergence Excess and Divergence Excess . . . 273
11 Normal AC/A Conditions: Fusional Vergence Dysfunction,
Basic Esophoria, and Basic Exophoria . . . . . . . . . . . . . . . . . . . . . . . . . . 307
12 Accommodative Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335
13 Eye Movement Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 368
14 Cyclovertical Heterophoria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389
15 Fixation Disparity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 429
IV Advanced Diagnostic and Management Issues
S E C T I O N
16 Interactions between Accommodation and Vergence . . . . . . . . . . . . . . 451
17 Refractive Amblyopia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 471
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Contents ix
18 Nystagmus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 491
19 Aniseikonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 517
20 Binocular and Accommodative Problems
Associated with Computer Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 547
21 Binocular and Accommodative Problems Associated with
Acquired Brain Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 571
22 Binocular and Accommodative Problems Associated
with Learning Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 593
23 Development and Management of Refractive Error:
Binocular Vision-based Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . 616
24 Binocular Vision Problems Associated with Refractive Surgery . . . . . . . 655
V Vision Therapy and Optometric Practice
S E C T I O N
25 Patient and Practice Management Issues in Vision Therapy . . . . . . . . . 674
Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 686
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 705
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