Bifoveal Fusion Recovery by Liquid Crystal Glasses in Children

Abstract

Introduction. Rehabilitation of visual functions in childhood is an urgent problem for pediatric ophthalmology. Researchers are constantlylooking for new rehabilitation measures for diseases such as myopia and retinopathy of prematurity. But timely and effectiveimplementation of rehabilitation measures to restore binocular functions in case of strabismus is not least important. Aim. This study aims to analyze bifoveal fusion recovery using method of LCD glasses with alternating occlusion of visual fields andcompare its efficacy with orthoptic treatment using synoptophore. Material and methods. Ninety-nine patients with prior esotropia, post-operative absence of bifoveal fusion and residual angle ofdeviation <10° were treated. All patients were hyperopic, the spherical refraction was not more than 4.75 diopters, the cylindricalrefraction not more than 1.5 diopters. At the same time, presence of mild amblyopia was allowed. Patients with vertical strabismusand cyclotropia identified during synoptophore examination and cyclotropy examination using Maddox rods, as well as patients withconcomitant ophthalmic pathology were excluded. All patients underwent a standard ophthalmological examination, as well as determinationof binocular vision by a 4-point test, a study on a synoptophore with the determination of the objective and subjectiveangles of strabismus. The main group included 46 patients who underwent treatment by alternating occlusion of visual fields with LCD glasses continuously for 4 hours/day, the control group included 53 patients who underwent synoptophore treatment for 12 months (3-4 courses). The observation period was 12 months. Results. Bifoveal fusion and binocular vision were significantly more often recovered by LCD glasses treatment as compared to thesinoptophore treatment. Stable bifoveal fusion was formed in 32 (69.5%) and 11 (21%) children, unstable in nine (19.6%) and two (4%); treatment was ineffective in five (10.9%) and 40 (75%) patients, respectively. Binocular vision was obtained in 18 (39.1%) and 11 (21%) patients, and taking into account the subsequent diploptic treatment in cases with unstable bifoveal fusion in 12 more patients (66.7%) in the main group. Conclusion. Alternating occlusion of visual fields with LCD glasses is a more effective mean of bifoveal fusion and binocular visionrecovery than orthoptic treatment with a synoptophore in patients after successful strabismus surgery.