By Carole Bowden, Simmons, Norris, Joanne Masters, Noble, Cunliffe, Richard R. Suminski, Jack J. Kanski, Anne Bolton, Ettinger, R. Muller, Roger, Devinksy
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Extra resources for Binocular Vision & Orthoptics
A distinction must be made between a functional loss of control of the vergence mechanism and pathological causes giving rise to incomitance. The investigation of incomitant deviations is covered in Chapter 12. This chapter reviews the non-pathological failure of vergence control typically seen in decompensated heterophoria. The compensation of a heterophoria describes the ease with which the fusional mechanisms (see Chapter 4) maintain control. A well-compensated heterophoria is associated with good stereopsis and symptom-free binocular vision.
Most patients can be taught voluntary convergence. There are a variety of mechanisms that may help the patient to converge voluntarily; some patients will use diplopia, and others imagine a bee flying towards the nose to trigger the convergence response. After repetitive exercises the patient will be aware of the proprioceptive feeling of the eyes being converged. Once the patient knows the feeling, it can be brought about at will and soon becomes reflexive. Patients with poor fusional convergence should complete their treatment with the appreciation of voluntary convergence to prevent regression.
Today, 37(21),32-5. Evans, B. J. W. (1997c). The evidencebased approach in optometry: Part 2. Optom. Today, 37(23). 33-7. Evans. B. J. W. (1997d). The evidencebased approach in optometry: Part 3. Optometric management of binocular visionanomalies Optom. Today. 35-8. Jennings. A. (2000). Behavioural optometry: a critical review. Optom. in Practice. 1, 67-7S. [ulesz, B. (1971). Foundations of Cyclopean Perception. University of Chicago Press. Grosvenor. T.. Perrigin, D. M.. Perrigin, J. and Masltvitz.