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Heterophoria

MedGen UID:
1671050
•Concept ID:
C4721400
•
Disease or Syndrome
Synonym: Heterophorias
 
HPO: HP:0032011

Definition

Heterophorias are latent deviations that are controlled by fusion. In certain circumstances (specific visual tasks, fatigue, illness, etc.), fusion can no longer be maintained and decompensation occurs. [from HPO]

Professional guidelines

PubMed

Creating consistency in the diagnosis of convergence insufficiency: screening methods.
Lavrich JB, Hamburger JL, Lee KE, Thuma TBT, Omega ML, Zhang QE, Gunton KB
J AAPOS 2023 Dec;27(6):346.e1-346.e6. Epub 2023 Nov 4 doi: 10.1016/j.jaapos.2023.08.019. PMID: 37931838
Accommodative spasm and its different treatment approaches: A systematic review.
Manna P, Karmakar S, Bhardwaj GK, Mondal A
Eur J Ophthalmol 2023 May;33(3):1273-1286. Epub 2022 Nov 16 doi: 10.1177/11206721221136438. PMID: 36384286
Management of digital eye strain.
Coles-Brennan C, Sulley A, Young G
Clin Exp Optom 2019 Jan;102(1):18-29. Epub 2018 May 23 doi: 10.1111/cxo.12798. PMID: 29797453

Recent clinical studies

Etiology

Convergence insufficiency: Review of clinical diagnostic signs.
Gantz L, Stiebel-Kalish H
J Optom 2022 Oct-Dec;15(4):256-270. Epub 2021 Dec 25 doi: 10.1016/j.optom.2021.11.002. PMID: 34963569Free PMC Article
Comparing proximal convergence ratio in myopes.
Vivekanand U, Lobo SG, Dharmappa N, Kesireddy A
Rom J Ophthalmol 2021 Oct-Dec;65(4):362-364. doi: 10.22336/rjo.2021.71. PMID: 35087977Free PMC Article
Management of digital eye strain.
Coles-Brennan C, Sulley A, Young G
Clin Exp Optom 2019 Jan;102(1):18-29. Epub 2018 May 23 doi: 10.1111/cxo.12798. PMID: 29797453
Acute-onset diplopia.
O'Colmain U, Gilmour C, MacEwen CJ
Acta Ophthalmol 2014 Jun;92(4):382-6. Epub 2013 Feb 7 doi: 10.1111/aos.12062. PMID: 23387838
Clinical findings before the onset of myopia in youth: 3. Heterophoria.
Goss DA, Jackson TW
Optom Vis Sci 1996 Apr;73(4):269-78. doi: 10.1097/00006324-199604000-00009. PMID: 8728495

Diagnosis

Accommodative spasm and its different treatment approaches: A systematic review.
Manna P, Karmakar S, Bhardwaj GK, Mondal A
Eur J Ophthalmol 2023 May;33(3):1273-1286. Epub 2022 Nov 16 doi: 10.1177/11206721221136438. PMID: 36384286
Convergence insufficiency: Review of clinical diagnostic signs.
Gantz L, Stiebel-Kalish H
J Optom 2022 Oct-Dec;15(4):256-270. Epub 2021 Dec 25 doi: 10.1016/j.optom.2021.11.002. PMID: 34963569Free PMC Article
Neuro-ophthalmologic exploration in non-functioning pituitary adenoma.
Abouaf L, Vighetto A, Lebas M
Ann Endocrinol (Paris) 2015 Jul;76(3):210-9. Epub 2015 Jun 10 doi: 10.1016/j.ando.2015.04.006. PMID: 26070465
Acute-onset diplopia.
O'Colmain U, Gilmour C, MacEwen CJ
Acta Ophthalmol 2014 Jun;92(4):382-6. Epub 2013 Feb 7 doi: 10.1111/aos.12062. PMID: 23387838
Clinical findings before the onset of myopia in youth: 3. Heterophoria.
Goss DA, Jackson TW
Optom Vis Sci 1996 Apr;73(4):269-78. doi: 10.1097/00006324-199604000-00009. PMID: 8728495

Therapy

Accommodative spasm and its different treatment approaches: A systematic review.
Manna P, Karmakar S, Bhardwaj GK, Mondal A
Eur J Ophthalmol 2023 May;33(3):1273-1286. Epub 2022 Nov 16 doi: 10.1177/11206721221136438. PMID: 36384286
Visual Performance and Binocular/Accommodative Function of S.T.O.P. Contact Lenses Compared With MiSight.
Tilia D, Diec J, Ehrmann K, Falk D, Fedtke C, Conrad F, Wu R, Bakaraju RC
Eye Contact Lens 2023 Feb 1;49(2):63-70. Epub 2022 Oct 19 doi: 10.1097/ICL.0000000000000950. PMID: 36282205Free PMC Article
Binocular vision disorders in a geriatric population.
Hashemi H, Nabovati P, Yekta AA, Agha Mirsalim M, Rafati S, Ostadimoghaddam H, Khabazkhoob M
Clin Exp Optom 2022 Jul;105(5):539-545. Epub 2021 May 20 doi: 10.1080/08164622.2021.1922065. PMID: 34016028
Vision therapy: Occlusion, prisms, filters, and vestibular exercises for mild traumatic brain injury.
Barton JJS, Ranalli PJ
Surv Ophthalmol 2021 Mar-Apr;66(2):346-353. Epub 2020 Aug 19 doi: 10.1016/j.survophthal.2020.08.001. PMID: 32827496
Use of botulinum toxin in small-angle heterotropia and decompensating heterophoria: a review of the literature.
Ripley L, Rowe FJ
Strabismus 2007 Jul-Sep;15(3):165-71. doi: 10.1080/09273970701506094. PMID: 17763254

Prognosis

Refractive changes with post-rotatory nystagmus in healthy individuals.
Hirota M, Takigawa R, Okabe C, Kato K, Nakagomi R, Sasaki K, Hayashi T
Int Ophthalmol 2022 Feb;42(2):559-573. Epub 2021 Oct 19 doi: 10.1007/s10792-021-02028-0. PMID: 34665371
Strabismus patterns after cataract surgery in adults.
Rossel-Zemkouo MJ, Bergholz R, Salchow DJ
Strabismus 2021 Mar;29(1):19-25. Epub 2021 Feb 25 doi: 10.1080/09273972.2021.1871635. PMID: 33632063
Objective Measurement of Fusional Vergence Ranges and Heterophoria in Infants and Preschool Children.
Sreenivasan V, Babinsky EE, Wu Y, Candy TR
Invest Ophthalmol Vis Sci 2016 May 1;57(6):2678-88. doi: 10.1167/iovs.15-17877. PMID: 27183054Free PMC Article
Neuro-ophthalmologic exploration in non-functioning pituitary adenoma.
Abouaf L, Vighetto A, Lebas M
Ann Endocrinol (Paris) 2015 Jul;76(3):210-9. Epub 2015 Jun 10 doi: 10.1016/j.ando.2015.04.006. PMID: 26070465
Near heterophoria in early childhood.
Babinsky E, Sreenivasan V, Candy TR
Invest Ophthalmol Vis Sci 2015 Jan 29;56(2):1406-15. doi: 10.1167/iovs.14-14649. PMID: 25634983Free PMC Article

Clinical prediction guides

Abnormal basic visual processing functions in binocular fusion disorders.
Benhaim-Sitbon L, Lev M, Polat U
Sci Rep 2023 Nov 7;13(1):19301. doi: 10.1038/s41598-023-46291-w. PMID: 37935803Free PMC Article
Comparing proximal convergence ratio in myopes.
Vivekanand U, Lobo SG, Dharmappa N, Kesireddy A
Rom J Ophthalmol 2021 Oct-Dec;65(4):362-364. doi: 10.22336/rjo.2021.71. PMID: 35087977Free PMC Article
Strabismus patterns after cataract surgery in adults.
Rossel-Zemkouo MJ, Bergholz R, Salchow DJ
Strabismus 2021 Mar;29(1):19-25. Epub 2021 Feb 25 doi: 10.1080/09273972.2021.1871635. PMID: 33632063
Correlations between clinical measures and symptoms: Report 2: Accommodative and vergence measures with symptoms.
Wajuihian SO
J Optom 2021 Apr-Jun;14(2):142-155. Epub 2020 Sep 1 doi: 10.1016/j.optom.2020.06.008. PMID: 32883648Free PMC Article
Neuro-ophthalmologic exploration in non-functioning pituitary adenoma.
Abouaf L, Vighetto A, Lebas M
Ann Endocrinol (Paris) 2015 Jul;76(3):210-9. Epub 2015 Jun 10 doi: 10.1016/j.ando.2015.04.006. PMID: 26070465

Recent systematic reviews

Accommodative spasm and its different treatment approaches: A systematic review.
Manna P, Karmakar S, Bhardwaj GK, Mondal A
Eur J Ophthalmol 2023 May;33(3):1273-1286. Epub 2022 Nov 16 doi: 10.1177/11206721221136438. PMID: 36384286

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