Evaluation on The Improvement of Ocular Movement Disorders Treated by Orthoptic Training Based on Physical Equilibrium Function Tests in Persons of Middle or Advanced Age

• Published in: JAPANESE ORTHOPTIC JOURNAL Vol. 31; pp. 57 - 65
• Main Author: Namba, Tetsuko
• Format: Journal Article
• Language: English
• Published: JAPANESE ASSOCIATION OF CERTIFIED ORTHOPTISTS 2002
• Subjects: acquired ocular movement disorder; balance master; middle or advanced age; orthoptic training; physical equilibrium function
• ISSN: 0387-5172; 1883-9215
• DOI: 10.4263/jorthoptic.31.57

Ocular movement disorders in persons of middle or advanced age often present with many visual functional abnormalities. Among such abnormalities, fusional disorders are treated by orthoptic training. Orthoptic training is frequently effective in alleviating adventitious superior oblique muscle palsy, one of the ocular movement disorders, and patients subjectively recognize that the symptoms improve. However, the treatment efficacy still needs to be evaluated both subjectively and objectively. In this study, the Balance Master (BM), measurement equipment for physical equilibrium function, was used. The BM provided a quantitative analysis of static and dynamic physical equilibrium functions before and after the treatment. Based on the results of this analysis, the relationship between the extent of optical function improvement after orthoptic training and physical equilibrium function was studied. Orthoptic training involves convergence training, saccadic eye movement training, fusional break and join training, fusional amplitude training and fusional side movement training. In the static physical equilibrium function tests, the center of gravity (COG) displacement measured by the BM when eyes were opened and closed after the treatment in middle or advanced aged subjects significantly decreased compared to that before the treatment. In the dynamic physical equilibrium function tests, subjects were required to shift their COG clockwisely in the eight directions. In middle or advanced aged subjects the COG displacement, particularly in the posterior direction, decreased after the treatment, indicating that the distance the COG had moved was shortened. We assume that these improvements were obtained because proprioceptors of deteriorated extraocular muscles were activated by orthoptic training, which consequently affected ocular movement and physical equilibrium function. Training for dynamic physical equilibrium function by the BM can be applied to a training by which a subjective symptom of disorders in binocular visual function is resolved. Similar to deterioration of physical equilibrium function with aging, this type of deterioration resulting from ocular movement disorders is an important factor with respect to the quality of life (QOL) among the aged.