Etiology of Heterophoria and Heterotropia

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Etiology of Heterophoria and Heterotropia

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Etiology of Heterophoria and Heterotropia Dr. Huseynova T. Briz-L Eye Clinic, Baku, Azerbaijan Chairman of ADMO YO www.admo.org.az tukezban@gmail.com

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Orthoforia occurs where both visual axes are directed towards the fixation point and do not deviate on dissociation.

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Factors that determine the relative position of the visual axes. Anatomical factors . Innervational factors.

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Factors Responsible for the Manifestation of a Deviation Abnormalities of Fusion Mechanism Reflexologic Theories

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Heterophoria

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Where heterophoria is presented, both visual axes are directed towards the fixation point but deviate on dissociation.

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Classification. Esophoria - convergence excess - divergence weakness - non-specific Exophoria - conveargence weakness - divergence excess - non-specific Hyperphoria/hypophoria Alternating hyperphoria/hypophoria Cyclophoria

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Aetiology. Esophoria Anatomical – enophthalmos, narrow IPD, extraocular muscle anomalies Refractive – suprable hypermetropia, anisometropia High AC/A ratio Weak negative fusional reserves

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Aetiology. Exophoria Anatomical – exophthalmos, wide IPD, extraocular muscle anomalies Refractive – acquired myopia, presbyopia, anisometropia Weak positive fusional reserves Passage of time

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Aetiology. Hyperphoria/hypophoria Refractive – high myopia (heavy eye syndrome) Weak vertical fusional reserves Anatomical – displaced globes, abnormal extraocular muscles, ptosis

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Heterotropia

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Heterotropia is a condition in which one or other visual axis is not directed towards the fixation point.

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There are a number of different forms of heterotropia: Esotropia Exotropia Hypertropia Hypotropia Cyclotropia Dissociated vertical deviation (DVD) Dissiciated horizontal deviation (DHD)

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Factors Causing the Deviation . Mechanical factors Structural anomalies of extraocular muscles Accommodation and refraction in comitant strabismus Fixation disparity Previous eye surgeries or brain surgeries

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Factors Causing the Deviation . Other Innervational (Neurologic) Factors in Comitant Strabismus. Paretic elements Anomalies of the brainstem Anomalies of convergence and divergence Vestibular system Anomalies of the visual pathway Brain damage Embryopathy

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