Excyclotropia of the Nonparetic Eye in Unilateral Superior Oblique Muscle Paralysis

doi:10.1016/0002-9394(82)90694-8

American Journal of Ophthalmology

Volume 93, Issue 1, January 1982, Pages 30-33

https://doi.org/10.1016/0002-9394(82)90694-8 Get rights and content

The Maddox double rod test showed subjective excyclotropia of the nonparetic eye in 15 of 60 patients with unilateral superior oblique muscle palsy. This response was reported consistently by patients who habitually fixated with the paretic eye. This phenomenon is the result of a monocular sensorial adaptation to the cyclodeviation by means of a reordering of the spatial response of retinal elements along new horizontal and vertical meridians. This study showed that the fixation preference must be determined to interpret correctly the results of the Maddox double rod test in patients with unilateral superior oblique muscle paralysis.

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Digital fundus photographs of both eyes of all study subjects were obtained using DRS CenterVue nonmydriatic fundus camera. Four separate measurements were made for each eye, and the DFA was calculated using Cyclocheck software independently by two observers to determine reproducibility and repeatability of the technique. The results were statistically analyzed using the interclass correlation coefficient (ICC) and the Bland-Altman method.
A total of 32 subjects (mean age, 34.4; range, 12-83) were enrolled: 18 were orthophoric; 14, strabismic. The ICC for the intraobserver repeatability for one observer was 0.979 (95% CI, 0.970-0.985; P < 0.0005) and for the other was 0.988 (95% CI, 0.983-0.991; P < 0.0005). The ICC for the interobserver agreement was 0.994 (95% CI, 0.992-0.996; P < 0.0005), indicating high reproducibility of the measurements.
Cyclocheck can assess ocular torsion quickly and easily. It provides reliable and reproducible measurements of the DFA and thus objective cyclodeviation in both orthophoric and strabismic subjects.
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This work was supported in part by a grant from the R. Samuel McLaughlin Foundation (Dr. Olivier).

Reprint requests to G. K. von Noorden, M.D., Department of Ophthalmology, Texas Children's Hospital, Box 20269, Houston, TX 77025.

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Excyclotropia of the Nonparetic Eye in Unilateral Superior Oblique Muscle Paralysis

Ophthalmology

Über die ophthalmoskopische Beobachtung gewisser Augenmuskelwirkungen

Albrecht von Graefes Arch. Ophthalmol.

Ectopies et pseudoectopies maculaires par rotation

Bull. Mem. Soc. Fr. Ophtalmol.

Über einige eigentümliche Lokalisationsphenomäne in einem Falle von hochgradiger Netzhautinkongruenz

Albrecht von Graefes Arch. Ophthalmol.