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Visual results with the use of prismatic lenses in the treatment of congenital nystagmus: a clinical case

dc.contributor.authorPoças, Ilda Maria
dc.contributor.authorLima, Pedro
dc.date.accessioned2016-08-11T14:32:56Z
dc.date.available2016-08-11T14:32:56Z
dc.date.issued2016-06
dc.description.abstractPurpose: It is important to establish a differential diagnosis between the different types of nystagmus, in order to give the appropriate clinical approach to every situation and to improve visual acuity. The nystagmus is normally blocked when the eyes are positioned in a particular way. This makes the child adopt a posture of ocular torticollis that reduces the nistagmiformes movements, improving the vision in this position. A way to promote the blocking of the nystagmic movements is by using prismatic lenses with opposite bases, to block or minimize the oscillatory movements. This results in a vision improvement and it reduces the anomalous head position. There is limited research on the visual results in children with nystagmus after using prisms with opposing bases. Our aim is to describe the impact on the visual acuity (VA ) of theprescription prism lenses in a nystagmus patient starting at 3 months of age. Methods: Case report on thirty month old caucasian male infant, with normal growth and development for their age, with an early onset of horizontal nystagmus at 3 months of age. Ophthalmic examination included slit lamp examination, fundus, refractive study, electrophysiological and magnetic resonance tests, measurement of VA over time with the Teller Acuity Cards (TAC ) in the distance agreed for the age. At age ten months, the mother noted a persistent turn to the right of the child’s head, which became increasingly more severe along the months. There’s no oscillopcia. At 24 months, an atropine refraction showed the following refractive error: 0D.: -1,50, OS: -0,50 and prismatic lens adapting OD 8 Δ nasal base and OE 8 Δ temporal base. Results: Thirty month old child, with adequate development for their age, with onset of idiopatic horizontal nystagmus, at 3 months of age. Normal ocular fundus and magnetic ressoance without alterations, sub-normal results in electrophysiological tests and VA with values below normal for age. At 6 months OD 20/300; OE 20/400; OU 20/300. At 9 months OD 20/250; OE 20/300; OU 20/150 (TAC a 38 cm). At 18 months OD 20/200; OE 20/100; OU 20/80 (TAC at 38 cm), when the head is turned to the right and the eyes in levoversão, the nystagmus decreases in a “neutral” area. At 24 month, with the prismatic glasses, OD 20/200 OE 20/100, OU20/80 (TAC at 54 cm, reference value is 20/30 – 20/100 para OU e 20/40 – 20/100 monocular), there was an increase in the visual acuity. The child did visual stimulation with multimedia devices and using glasses. After adaptation of prisms: at 30 months VA (with Cambridge cards) OD e OE = 6/18. The child improved the VA and reduced the anomalous head position. There is also improvement in mobility and fine motricity. Conclusion: Prisms with opposing bases., were used in the treatment of idiopathic nystagmus. Said prisms were adapted to reduce the skewed position of the head, and to improve VA and binocular function. Monitoring of visual acuity and visual stimulation was done using electronic devices. Following the use of prismatic, the patient improved significantly VA and the anomalous head position was reduced.pt_PT
dc.identifier.citationPoças IM, Lima P. Visual results with the use of prismatic lenses in the treatment of congenital nystagmus: a clinical case. In: XIII International Orthoptic Congress, Rotterdam (Netherlands), 27-30 June 2016.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/6359
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.relation.publisherversionhttp://ioacongress2016.org/wp-content/uploads/2016/06/IOA_Abstract_27jun.pdfpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectOrthopticspt_PT
dc.subjectCongenital nystagmuspt_PT
dc.subjectPrismatic lensespt_PT
dc.subjectVisual acuitypt_PT
dc.subjectVisual stimulationpt_PT
dc.subjectChildrenpt_PT
dc.titleVisual results with the use of prismatic lenses in the treatment of congenital nystagmus: a clinical casept_PT
dc.typeconference object
dspace.entity.typePublication
oaire.citation.conferencePlaceRoterdãopt_PT
person.familyNamePoças
person.givenNameIlda Maria
person.identifier.ciencia-id1E1A-86A4-BC50
person.identifier.orcid0000-0002-1695-3231
rcaap.rightsopenAccesspt_PT
rcaap.typeconferenceObjectpt_PT
relation.isAuthorOfPublicationced35a9f-848a-49c9-91dc-f60f679f149f
relation.isAuthorOfPublication.latestForDiscoveryced35a9f-848a-49c9-91dc-f60f679f149f

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