Abstract
Background
To assess the presence and extent of photophobia in children with intermittent exotropia (X[T]) using the contrast sensitivity test.
Methods
Fifty-eight children with X(T) and 34 normal controls were studied with the functional acuity contrast test. Each participant viewed the stimuli of contrast monocularly and binocularly under photopic and mesopic conditions, performed with and without glare. Photophobia was defined as a reduction of contrast sensitivity caused by glare light. We compared the photophobia of children with X(T) to that of normal controls, and to the photophobia 3 months after muscle surgery.
Results
With stimuli of glare, the contrast sensitivity of children with X(T) was suppressed at intermediate spatial frequencies under mesopic condition (p = 0.006 for 6 cycles per degree [cpd], p = 0.027 for 12 cpd), whereas that of normal controls showed no difference. It occurred when X(T) patients viewed targets binocularly, and significantly improved after strabismus surgery (p = 0.003 at 6 cpd). The measured photophobia of X(T) was strongly correlated to the photophobia symptoms reported by parents (p = 0.002).
Conclusions
The mesopic contrast sensitivity with glare can represent the photophobia of children with X(T). Contrast sensitivity may be a useful measure for monitoring symptoms related to X(T).
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References
Wang FM, Chryssanthou G (1988) Monocular eye closure in intermittent exotropia. Arch Ophthalmol 106:941–942
Song SJ, Kim MM (2000) The photophobia incidence, stereopsis and suppression in intermittent exotropia. J Korean Ophthalmol Soc 41:2254–2257
Lew H, Kim CH, Yun YS, Han SH (2007) Binocular photophobia after surgical treatment in intermittent exotropia. Optom Vis Sci 84:1101–1103
Stringham JM, Fuld K, Wenzel AJ (2003) Action spectrum for photophobia. J Opt Soc Am A Opt Image Sci Vis 20:1852–1858
Stringham JM, Fuld K, Wenzel AJ (2004) Spatial properties of photophobia. Investig Ophthalmol Vis Sci 45:3838–3848
Lebensohn JE (1951) Photophobia: mechanism and implications. Am J Ophthalmol 34:1294–1300
Wiggins RE, von Noorden GK (1990) Monocular eye closure in sunlight. J Pediatr Ophthalmol Strabismus 27:16–20
Hohberger B, Laemmer R, Adler W, Juenemann AG, Horn FK (2007) Measuring contrast sensitivity in normal subjects with OPTEC 6500: influence of age and glare. Graefes Arch Clin Exp Ophthalmol 245:1805–1814
Rocha KM, Soriano ES, Chalita MR, Yamada AC, Bottós K, Bottós J, Morimoto L, Nosé W (2006) Wavefront analysis and contrast sensitivity of aspheric and spherical intraocular lenses: a randomized prospective study. Am J Ophthalmol 142:750–756
Boxer Wachler BS, Durrie DS, Assil KK, Krueger RR (1999) Improvement of visual function with glare testing after photorefractive keratectomy and radial keratotomy. Am J Ophthalmol 128:582–587
Aslam TM, Haider D, Murray IJ (2007) Principles of disability glare measurement: an ophthalmological perspective. Acta Ophthalmol Scand 85:354–360
Fawcett SL (2005) Disruption and reacquisition of binocular vision in childhood and in adulthood. Curr Opin Ophthalmol 16:298–302
Huang C, Tao L, Zhou Y, Lu ZL (2007) Treated amblyopes remain deficient in spatial vision: a contrast sensitivity and external noise study. Vis Res 47:22–34
Campos EC, Cipolli C (1992) Binocularity and photophobia in intermittent exotropia. Percept Mot Skills 74:1168–1170
Clarke MP (2007) Intermittent exotropia. J Pediatr Ophthalmol Strabismus 44:153–157
Serrano-Pedraza I, Clarke MP, Read JC (2011) Single vision during ocular deviation in intermittent exotropia. Ophthalmic Physiol Opt 31:45–55
Ginsborg BL, Maurice DM (1959) Involuntary movements of the eye during fixation and blinking. Br J Ophthalmol 43:435–437
Stella SL (1968) The association of blinks and refusion in intermittent exotropia. Am J Optom Arch Am Acad Optom 45:465–471
Rambold H, Sprenger A, Helmchen C (2002) Effects of voluntary blinks on saccades, vergence eye movements, and saccade-vergence interactions in humans. J Neurophysiol 88:1220–1233
Khawam E, Zein W, Haddad W, Haddad C, Allam S (2003) Intermittent exotropia with high ac/a ratio: is it a bane to surgical cure? some facts and fictions of the two clinical tests: occlusion of one eye and the use of +3.00 spherical lenses. Binocul Vis Strabismus Q 18:209–216
Hatt SR, Leske DA, Holmes JM (2009) Awareness of exodeviation in children with intermittent exotropia. Strabismus 17:101–106
Livingstone MS, Hubel DH (1988) Segregation of form, color, movement and depth: anatomy, physiology, and perception. Science 240:740–749
Kaplan E, Shapley RM (1986) The primate retina contains two types of ganglion cells, with high and low contrast sensitivity. Proc Natl Acad Sci U S A 83:2755–2757
McKee SP, Levi DM, Movshon JA (2003) The pattern of visual deficits in amblyopia. J Vis 3:380–405
Moseley MJ, Stewart CE, Fielder AR, Stephens DA, MOTAS cooperative (2006) Intermediated spatial frequency letter contrast sensitivity: its relation to visual resolution before and during amblyopia treatment. Ophthalmic Physiol Opt 26:1–4
Repka MX, Kraker RT, Beck RW, Cotter SA, Holmes JM, Arnold RW, Astle WF, Sala NA, Tien DR, Pediatric Eye Disease Investigator Group (2009) Contrast sensitivity following amblyopia treatment in children. Arch Ophthalmol 127:1225–1227
von Noorden GK, Campos EC (2002) The near vision complex. In: von Noorden GK, Campos EC (eds) Binocular Vision and Ocular Motility. Theory and Management of Strabismus. Mosby, St Louis, p 98
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Chung, S.A., Rhiu, S., Han, S.H. et al. Photophobia measurement in intermittent exotropia using the contrast sensitivity test. Graefes Arch Clin Exp Ophthalmol 251, 1405–1411 (2013). https://doi.org/10.1007/s00417-012-2241-z
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DOI: https://doi.org/10.1007/s00417-012-2241-z