esophoria
Introduction
Introduction to implicit skew Esophoria is the tendency of the eye to have an inward deflection. It can be controlled by corrective fusion reflex, without oblique position, and can maintain binocular monocular. Generally, the implicit slant can exceed the symptoms of 9 . But it depends on the patient's fusion function. The visual reflex of both eyes in infancy and early childhood is unstable, and the fluctuations gradually decrease afterwards. The 5-year-old basically stops, and the 8-year-old volatility period basically ends. If there are no serious obstacles, it will remain for life, but in this unstable period, any influence on both eyes A single visual disorder can cause strabismus, and any strabismus can result in loss of binocular monocular function. Symptoms of implicit obliqueness mainly include eye pain, headache, and visual distortion. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: blepharitis
Cause
Implicit oblique cause
Eye muscle factor (25%):
The eye muscles include the orbicularis muscle, the extraocular muscles, the superior levator muscle, the superior rectus muscle, the superior oblique muscle, the lateral rectus muscle, the inferior oblique muscle, the inferior rectus muscle, and the medial rectus muscle, which can cause the inner oblique oblique In the rectus muscle, the inner rectus muscle is strong or the attachment point is front, the outer muscle is weak or the attachment is occupied, and the interstitial membrane of the ligament is abnormal.
Disease factors (15%):
Hyperopia refers to the formation of a focus behind the retina after parallel rays enter the eye, and external objects cannot form a clear image in the retina. Excessive use of hyperopic eye adjustment can induce excessive convergence, causing implicit oblique, and the implicit oblique is the highest proportion in the oblique.
Neurological factors (45%):
One of the important factors that cause this disease is that the central convergence is too strong.
Prevention
Implicit slope prevention
The visual reflex of both eyes in infancy and early childhood is unstable, and the fluctuations gradually decrease afterwards. The 5-year-old basically stops, and the 8-year-old volatility period basically ends. If there are no serious obstacles, it will remain for life, but in this unstable period, any influence on both eyes Single visual obstacles can lead to strabismus, and any strabismus can lead to loss of monocular function in both eyes. On the other hand, due to the unstable formation of binocular monocular function during this period, it is easy to lose and easy to recover. If strabismus is found, early treatment, as early as possible Treatment can not only correct strabismus, but also restore the loss or dysplasia of the binocular monocular function, thus achieving the ideal purpose of functional cure. Conversely, if the treatment is delayed and the visual function development period is missed, the binocular monocular function is lost. The skeletal deformity and the compensated head position can not be restored. Even if the strabismus is corrected by surgery, it is only a cosmetic correction, and there is no "adhesive" effect of the binocular single vision function, and there is still the risk of strabismus again.
Complication
Implicit complication Complications
Symptom
Implicit oblique symptoms common symptoms visual distortion eye pain
Symptoms of implicit obliqueness: eye pain, headache, and visual distortion. The deformation of the object is caused by the lesion of the retina or the macula, which causes the image of the object to be distorted and changed. When looking at distant objects, such as watching movies, ball games, walking, observation of the scenery, the symptoms are more obvious, headache, eye pain, blurred vision and general malaise, heavier implicit oblique positioning and stereoscopic function is not good, implicit The oblique patient usually likes to look up to relieve the symptoms, because the eye position can be overcome to partially overcome the hidden inclination when looking up.
Examine
Implicit oblique inspection
Implicit oblique inspection items: Markov rods, covering methods, refractive examination.
The occlusion method is the easiest and most convenient method for strabismus examination. It can determine not only strabismus but also which strabismus. Normal value of occlusion method: cover the patient's right eye, and the left eye still looks at the target in front without movement. Open the patient's right eye. If the left eye is still not moving, the right eye appears to move. According to the direction of the movement, the patient can be judged to be implicit or oblique. If the right eye moves from the inside to the outside, it means suffering from implicit strabismus; from the outside to the inside, it means suffering from external oblique.
Maddox is an important and indispensable tool for binocular visual function tests. The Markov rod can be used for horizontal and vertical recessive strabismus; rotary recessive strabismus; It has important reference value in evaluating binocular vision function and disposing of binocular vision abnormalities. Normal value of the Markov rod: put a point-like target or a bunch of spot light. Looking at the point light through the madox rod will look like a strip of light perpendicular to the Markov rod.
1. Physical examination: the application of alternating cover method, Mars rod inspection law to determine the presence or absence of hidden oblique; triangular prism method, hidden oblique meter can accurately determine the degree of hidden slope.
2. Auxiliary examination: The refractive state should be checked.
Diagnosis
Implicit diagnosis
Differential diagnosis
1. Refractive error.
Refractive error refers to the fact that when the eye is not used for adjustment, the parallel light passes through the refractive power of the eye, and can not form a clear object image on the retina, but is imaged in front of or behind the retina, including farsightedness, myopia, and astigmatism.
The line is covered by the alternating cover method, and when the cover is covered, there is no movement of the eye.
2. Intermittent exotropia.
Intermittent exotropia (intermitentexotropia) is a kind of strabismus between the oblique slant and the common exotropia. It means that the visual axis is often separated, which occurs at the beginning of the distance. When looking far, the fusion spreads. Exceeding the convergence range of the fullness, that is, the external oblique is generated, and before the occurrence of the intermittent external squint, there is an external oblique.
Long-distance gaze is obvious, but it can generally be imaged when looking at close distance, and it does not appear as eyeball skew.
