Re: Economides et  al.: Capturing the moment of fusion loss in intermittent exotropia (Ophthalmology. 2017;124;496-504)

Based on the eye tracker recording data presented, I can agree with the conclusion on page 503 in the discussion section that states “once the ocular axes separate, visual feedback has no impact on the subsequent outward movement of the deviating eye to its final position.”1 However, the abstract conclusion implies something different, stating that the process of fusion loss itself in patients with intermittent exotropia is n ot influenced by visual feedback. Semantics perhaps, but as a clinician who has examined 20 or 30 of these patients weekly for the past 17 years, how else to explain the consistently reported symptom of unilateral lid squinting in bright, outdoor sunlight, almost universally accepted by clinicians a s natural history, a powerful, nonrandom dissociation to the tropic phase inducing blur or diplopia, and hence the observed compensatory lid closure?

Source: Ophthalmology - January 18, 2018 Category: Opthalmology Authors: Alex Christoff Tags: Correspondence Source Type: research