Abstract
Purpose
To determine the relationship between re-reading the same line and saccadic disconjugacy in patients with convergence insufficiency-type intermittent exotropia [CI-type X(T)].
Methods
Eight patients with CI-type X(T) and ten healthy orthophoric individuals were studied. Video-oculography was used to assess the eye movements during the reading of a Japanese novel displayed on a 23-in. liquid crystal monitor placed 60 cm from the eyes. The sentences were displayed horizontally and read from left to right. The number of unintentional re-readings of the same line was counted, and the disconjugacy at the median of the saccade between the end of a line and the next line was determined.
Results
The number of re-readings of the same line in patients with CI-type X(T) was 4.9 ± 2.3 times which was significantly higher than that in the controls at 0.2 ± 0.4 times (P < 0.001). The saccadic disconjugacy was significantly larger in patients with CI-type X(T) at −1.70° ± 0.72° than that in the controls at −0.40°± 0.30° (P < 0.001). The number of re-readings of the same line was significantly and positively correlated with the saccadic disconjugacy (R = 0.84, R 2 = 0.71, P < 0.01).
Conclusions
The results of our study indicate that saccadic disconjugacy is associated with re-reading the same line in patients with CI-type X(T).
Similar content being viewed by others
References
Mohney BG, Huffaker RK. Common forms of childhood exotropia. Ophthalmology. 2003;110:2093–6.
Matsuo T, Matsuo C. The prevalence of strabismus and amblyopia in Japanese elementary school children. Ophthalmic Epidemiol. 2005;12:31–6.
Chia A, Roy L, Seenyen L. Comitant horizontal strabismus: an Asian perspective. Br J Ophthalmol. 2007;91:1337–40.
Burian HM. Exodeviations—their classification, diagnosis, and treatment. Am J Ophthalmol. 1966;62:1161–6.
Wang FM, Chryssanthou G. Monocular eye closure in intermittent exotropia. Arch Ophthalmol. 1988;106:941–2.
Hatt SR, Gnanaraj L. Interventions for intermittent exotropia. Cochrane Database Syst Rev. 2013;5:CD003737.
Cooper J, Duckman R. Convergence insufficiency: incidence, diagnosis, and treatment. J Am Optom Assoc. 1978;49:673–80.
Cooper J, Jamal N. Convergence insufficiency—a major review. Optometry. 2012;83:137–58.
Westman M, Liinamaa MJ. Relief of asthenopic symptoms with orthoptic exercises in convergence insufficiency is achieved in both adults and children. J Optom. 2012;5:62–7.
Clark TY, Clark RA. Convergence insufficiency symptom survey scores for reading versus other near visual activities in school-age children. Am J Ophthalmol. 2015;160:905.e2–912.e2.
Saunte JP, Christensen T. Improvement in reading symptoms following botulinum toxin A injection for convergence insufficiency type intermittent exotropia. Acta Ophthalmol. 2015;93:e391–2.
Saunte JP, Holmes JM. Sustained improvement of reading symptoms following botulinum toxin A injection for convergence insufficiency. Strabismus. 2014;22:95–9.
Borsting EJ, Rouse MW, Mitchell GL, Scheiman M, Cotter SA, Cooper J, et al. Validity and reliability of the revised convergence insufficiency symptom survey in children aged 9 to 18 years. Optom Vis Sci. 2003;80:832–8.
Dusek W, Pierscionek BK, McClelland JF. A survey of visual function in an Austrian population of school-age children with reading and writing difficulties. BMC Ophthalmol. 2010;10:16.
Scheiman M, Cotter S, Rouse M, Mitchell GL, Kulo M, Cooper J, et al. Randomised clinical trial of the effectiveness of base-in prism reading glasses versus placebo reading glasses for symptomatic convergence insufficiency in children. Br J Ophthalmol. 2005;89:1318–23.
Elliott DB, TrukoloIlic M, Strong JG, Pace R, Plotkin A, Bevers P. Demographic characteristics of the vision-disabled elderly. Investig Ophthalmol Vis Sci. 1997;38:2566–75.
Lightstone A, Evans BJ. A new protocol for the optometric management of patients with reading difficulties. Ophthalmic Physiol Opt. 1995;15:507–12.
Ribeiro GD, Zum Bach AG, Faria CM, Anastasia S, de Almeida HC. Quality of life of patients with strabismus. Arq Bras Oftalmol. 2014;77:110–3.
Coubard OA. Saccade and vergence eye movements: a review of motor and premotor commands. Eur J Neurosci. 2013;38:3384–97.
Bucci MP, Kapoula Z. Binocular coordination of saccades in 7-year-old children in single word reading and target fixation. Vis Res. 2006;46:457–66.
Lions C, Bui-Quoc E, Seassau M, Bucci MP. Binocular coordination of saccades during reading in strabismic children. Investig Ophthalmol Vis Sci. 2013;54:620–8.
Dusek WA, Pierscionek BK, McClelland JF. An evaluation of clinical treatment of convergence insufficiency for children with reading difficulties. BMC Ophthalmol. 2011;11:21.
Convergence Insufficiency Treatment Trial Study G. The convergence insufficiency treatment trial: design, methods, and baseline data. Ophthalmic Epidemiol. 2008;15:24–36.
Cooper J, Feldman J. Reduction of symptoms in binocular anomalies using computerized home therapy-HTS (TM). Optometry. 2009;80:481–6.
Liebermann L, Hatt SR, Leske DA, Holmes JM. Improvement in specific function-related quality-of-life concerns after strabismus surgery in nondiplopic adults. J AAPOS. 2014;18:105–9.
Acknowledgments
This study was supported by the Translational Research Network Program from the Ministry of Education, Culture, Sports, Science and Technology, Japan, B03, Development of STS retinal prosthesis for walking, Takashi Fujikado; Asian CORE Program, Japan Society for the Promotion of Science (JSPS), Advanced Nano Photonics Research and Education Center in Asia, Satoshi Kawata; JSPS Core-to-Core Program, A, Advanced Research Networks, Minoru Asada; KAKENHI (25293354), The Ministry of Education, Culture, Sports, Science and Technology Japan (MEXT) Grant-in-Aid for Scientific Research (B), Takashi Fujikado.
Conflicts of interest
M. Hirota, None; H. Kanda, None; T. Endo, None; T. K. Lohmann, None; T. Miyoshi, None; T. Morimoto, None; T. Fujikado, None.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
10384_2016_444_MOESM1_ESM.mpg
Online Resource 1. An example of eye movement recording while reading in a normal subject. Normal subjects can move their eyes in small saccades while reading the same line and in a large saccade from the end of the line to the beginning of the next line. The filled red circle indicates the point at which the fixating point of both eyes is averaged. The size of the red circle represents the retention time. CI-type X(T): convergence insufficiency type intermittent exotropia (MPG 5064 kb)
10384_2016_444_MOESM2_ESM.mpg
Online Resource 2. An example of eye movement recording while reading in patients with CI-type X(T). When a patient with CI-type X(T) moves his/her eyes from one line to the next line, they occasionally return their eyes to the beginning of the same line after a saccade. Then, they make a saccade again to the end of the same line because the sentence does not make sense. CI-type X(T): convergence insufficiency type intermittent exotropia (MPG 4806 kb)
About this article
Cite this article
Hirota, M., Kanda, H., Endo, T. et al. Relationship between reading performance and saccadic disconjugacy in patients with convergence insufficiency type intermittent exotropia. Jpn J Ophthalmol 60, 326–332 (2016). https://doi.org/10.1007/s10384-016-0444-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10384-016-0444-2