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Utility of Ocular Motility Tests in Orbital Floor Fractures with Muscle Entrapment That is Not Detected on Computed Tomography
PURPOSE: Determine the usefulness of ocular motility testing to detect the presence of muscle entrapment. MATERIALS AND METHODS: Cross-sectional study of patients with symptoms of diplopia secondary to facial trauma. Inclusion criteria: age between 20 and 80 years; symptoms of diplopia following fac...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079357/ https://www.ncbi.nlm.nih.gov/pubmed/33935485 http://dx.doi.org/10.2147/OPTH.S292097 |
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author | Migliorini, Raffaele Comberiati, Anna Maria Pacella, Fernanda Longo, Anna Rosy Messineo, Daniela Trovato Battagliola, Edoardo Malvasi, Mariaelena Pacella, Elena Arrico, Loredana |
author_facet | Migliorini, Raffaele Comberiati, Anna Maria Pacella, Fernanda Longo, Anna Rosy Messineo, Daniela Trovato Battagliola, Edoardo Malvasi, Mariaelena Pacella, Elena Arrico, Loredana |
author_sort | Migliorini, Raffaele |
collection | PubMed |
description | PURPOSE: Determine the usefulness of ocular motility testing to detect the presence of muscle entrapment. MATERIALS AND METHODS: Cross-sectional study of patients with symptoms of diplopia secondary to facial trauma. Inclusion criteria: age between 20 and 80 years; symptoms of diplopia following facial trauma; presence of orbital floor fracture confirmed radiologically; presence of muscle entrapment confirmed at the time of surgery; best-corrected visual acuity of 0.6 or more. Exclusion criteria: muscle entrapment visible on computed tomography; candidate for immediate surgical correction; prior history of strabismus surgery. Outcome measures: Abnormal Head Position (AHP), Hirschberg Corneal Reflexes (CR), Cover/Uncover and Alternating Cover Test, Hertel exophthalmometry, Near Point of Convergence (NPC), Kestenbaum Limbus test, Red Filter test, and Hess screen test. RESULTS: Forty-six subjects (38 males, 8 females, mean age 27 ± 3.3 SD years). Pre-operative assessment: forty-six (100%) reported diplopia on the Red Filter test and showed some degree of abnormality on the Hess Screen test. Forty-two (91%) showed AHP. Forty-one (89%) had exophthalmometry values that differed 2 mm or more between the two eyes and insufficient NPC. Thirty-two (69.6%) showed deficits of 3 mm or more on the Kestenbaum Limbus test. Sixteen (35%) had abnormal Hirschberg corneal reflexes. Eleven (24%) demonstrated constant or intermittent strabismus. CONCLUSION: Ocular motility testing can differentiate non-invasively, pre-operatively, and cost-effectively the presence of muscle entrapment even when this is not visible on computed tomography. |
format | Online Article Text |
id | pubmed-8079357 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-80793572021-04-29 Utility of Ocular Motility Tests in Orbital Floor Fractures with Muscle Entrapment That is Not Detected on Computed Tomography Migliorini, Raffaele Comberiati, Anna Maria Pacella, Fernanda Longo, Anna Rosy Messineo, Daniela Trovato Battagliola, Edoardo Malvasi, Mariaelena Pacella, Elena Arrico, Loredana Clin Ophthalmol Original Research PURPOSE: Determine the usefulness of ocular motility testing to detect the presence of muscle entrapment. MATERIALS AND METHODS: Cross-sectional study of patients with symptoms of diplopia secondary to facial trauma. Inclusion criteria: age between 20 and 80 years; symptoms of diplopia following facial trauma; presence of orbital floor fracture confirmed radiologically; presence of muscle entrapment confirmed at the time of surgery; best-corrected visual acuity of 0.6 or more. Exclusion criteria: muscle entrapment visible on computed tomography; candidate for immediate surgical correction; prior history of strabismus surgery. Outcome measures: Abnormal Head Position (AHP), Hirschberg Corneal Reflexes (CR), Cover/Uncover and Alternating Cover Test, Hertel exophthalmometry, Near Point of Convergence (NPC), Kestenbaum Limbus test, Red Filter test, and Hess screen test. RESULTS: Forty-six subjects (38 males, 8 females, mean age 27 ± 3.3 SD years). Pre-operative assessment: forty-six (100%) reported diplopia on the Red Filter test and showed some degree of abnormality on the Hess Screen test. Forty-two (91%) showed AHP. Forty-one (89%) had exophthalmometry values that differed 2 mm or more between the two eyes and insufficient NPC. Thirty-two (69.6%) showed deficits of 3 mm or more on the Kestenbaum Limbus test. Sixteen (35%) had abnormal Hirschberg corneal reflexes. Eleven (24%) demonstrated constant or intermittent strabismus. CONCLUSION: Ocular motility testing can differentiate non-invasively, pre-operatively, and cost-effectively the presence of muscle entrapment even when this is not visible on computed tomography. Dove 2021-04-23 /pmc/articles/PMC8079357/ /pubmed/33935485 http://dx.doi.org/10.2147/OPTH.S292097 Text en © 2021 Migliorini et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Migliorini, Raffaele Comberiati, Anna Maria Pacella, Fernanda Longo, Anna Rosy Messineo, Daniela Trovato Battagliola, Edoardo Malvasi, Mariaelena Pacella, Elena Arrico, Loredana Utility of Ocular Motility Tests in Orbital Floor Fractures with Muscle Entrapment That is Not Detected on Computed Tomography |
title | Utility of Ocular Motility Tests in Orbital Floor Fractures with Muscle Entrapment That is Not Detected on Computed Tomography |
title_full | Utility of Ocular Motility Tests in Orbital Floor Fractures with Muscle Entrapment That is Not Detected on Computed Tomography |
title_fullStr | Utility of Ocular Motility Tests in Orbital Floor Fractures with Muscle Entrapment That is Not Detected on Computed Tomography |
title_full_unstemmed | Utility of Ocular Motility Tests in Orbital Floor Fractures with Muscle Entrapment That is Not Detected on Computed Tomography |
title_short | Utility of Ocular Motility Tests in Orbital Floor Fractures with Muscle Entrapment That is Not Detected on Computed Tomography |
title_sort | utility of ocular motility tests in orbital floor fractures with muscle entrapment that is not detected on computed tomography |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079357/ https://www.ncbi.nlm.nih.gov/pubmed/33935485 http://dx.doi.org/10.2147/OPTH.S292097 |
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