Exophoria: clinical features, diagnosis, treatment. The modern view on the problem. Literature review

Abstract

Purpose. Create a summary classification of exophoria. To propose an optimal algorithm for optometric and surgical methods of treatment. A modern view of the problem. It is optimal to subdivide exophoria according to the state of the vergent-duction balance into divergence excess, basic exophoria, convergence insufficiency, divergence pseudo-excess, lateral gaze incomitance. By the degree of compensation for compensated, subcompensated, uncompensated, decompensated. In combination with alphabetic pattern for exophoria without pattern, exophoria in combination with horizontal type A pattern, exophoria in combination with vertical type A pattern, exophoria in combination with horizontal type V pattern, exophoria in combination with vertical type V pattern. Features of optimal optical and prismatic correction depend on the state of the vergent-duction balance. In cases of exophoria without pattern surgical treatment is carried out during the transition from a state of subcompensation to non-compensation. In case of exophoria with horizontal-type alphabetical pattern, combined horizontal-transpositional surgery is optimal: elimination of exophoria, the protocol is based on the amount of deviation in the direct gaze position; elimination of the pattern, the protocol is based on vertical transposition of muscles of horizontal action. In cases of exophoria with vertical-type pattern, it is necessary to perform staged vertical-horizontal surgery: stage 1 – elimination of vertical heterotropy in adduction; stage 2 – elimination of exophoria (the protocol is based on the amount of deviation in the direct gaze position). Conclusions. The treatment protocol should be based on a reliably diagnosed diagnosis and consists at the pre-surgical stage in the optimal optical and prismatic correction, the appointment of orthopto-diplopto-prismatic treatment. The effectiveness of treatment is assessed by the dynamics of the disease: the magnitude of exodeviation and the stage of compensation. The protocol of surgical treatment must be reasonable and timely. Key words: exophoria, divergence excess, convergence insufficiency, basic exotropia, lateral gaze incomitance, alphabet pattern.