Detecting Binocular Diplopia in Orbital Floor Blowout Fractures: Superiority of the Orthoptic Approach

0548627 - ÚŽFG 2022 RIV LT eng J - Journal Article
Timkovič, J. - Stránský, J. - Handloš, P. - Janošek, J. - Tomášková, H. - Štembírek, Jan
Detecting Binocular Diplopia in Orbital Floor Blowout Fractures: Superiority of the Orthoptic Approach.
Medicina-Lithuania. Roč. 57, č. 9 (2021), č. článku 989. ISSN 1010-660X. E-ISSN 1648-9144
Institutional support: RVO:67985904
Keywords : diplopia * orthoptic examination * orbital blowout fractures
OECD category: Otorhinolaryngology
Impact factor: 2.948, year: 2021
Method of publishing: Open access
https://www.mdpi.com/1648-9144/57/9/989

Background and Objectives: In patients with orbital floor blowout fracture (OFBF), accurate diagnosis of ocular motility disorder is important for decisions about conservative or surgical therapy. However, the accuracy of the traditional test for detecting binocular diplopia/ocular motility disorder using a moving pencil or finger (hereinafter, finger test) has been generally accepted as correct and has not been subject to scrutiny so far. Hence, its accuracy relative to full orthoptic examination is unknown. Materials and Methods: In this paper, the results of the finger test were compared with those derived from a complex examination by orthoptic tests (considered true value in patients with OFBF). Results: Finger test detected ocular motility disorder in 23% of patients while the full orthoptic examination proved much more efficient, detecting ocular motility disorder in 65% of patients. Lancaster screen test and test with color filters were the most important tests in the battery of the orthoptic tests, capable of identifying 97.7% and 95.3% of patients with ocular motility disorder, respectively. Still, none of the tests were able to correctly detect all patients with ocular motility disorder in itself. Conclusions: As the presence of ocular motility disorder/binocular diplopia is an important indication criterion for the surgical solution of the orbital floor blowout fracture, we conclude that a complex orthoptic evaluation should be always performed in these patients.
Permanent Link: http://hdl.handle.net/11104/0324664