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Near Point of Convergence in Intermittent Exotropia

Sanjeev Bhattarai1*, Kishor Sapkota2, Jeevan Kumar Shrestha1, Ramchandra Lamichhane3 and Douk Hoon Kim4
1BP Koirala Lions Center of Ophthalmic Studies, Institute of Medicine, Kathmandu, Nepal
2Department of Physics & Optometry, University of Minho, Portugal
3Department of Ophthalmology, Civil Hospital, Kathmandu, Nepal
4Department of Optometry, Masan University, Korea
*Corresponding Author: Sanjeev Bhattarai, Assistant Lecturer, BP Koirala Lions Center of Ophthalmic Studies, Maharajgunj, Kathmandu, Nepal, Tel: (+977) 9841509323, Email: bhattarai_sanjeev@yahoo.com

Copyright: © 2020  . This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 
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Abstract

Introduction: Intermittent exotropia (IXT) is the most common type of exo-deviation. Patients with IXT can maintain binocular single vision (BSV) and the duration of binocular disruption depends upon its severity and the status of convergence mechanism. Those patients with good near point of convergence (NPC) can use BSV most of the time. Aim: To determine NPC in patients with IXT. Materials and methods: It was a hospital based cross-sectional study conducted in BP Koirala Lions Center of Ophthalmic Studies over a period of one year starting from Janaury 2009. All patients with IXT and age ranging from 5-35 yrs were included in this study. Complete ophthalmologic examination was done including measurement of NPC with RAF rule and magnitude of deviation with Synaptophore. Results: Out of 115 patients, majority of patients (58%) were students and headache was found to be the most common complaint (65%). Two thirds of patients had IXT of 10-25 PD at near while half of patients had IXT of < 10 PD at distance. Mean NPC was 13.27 ± 3.46 cm. Two-thirds of the patients had NPC of 10 cm or more. NPC was not associated with age and gender of patients (p ≥ 0.05). 74% of patients had normal near point of accommodation (NPA) according to their age. Four fifths of patients had normal visual acuity in both eyes. Almost all (98%) of patients had positive stereopsis at near but at distance, 77% of patients had positive stereopsis. Conclusion: NPC is poor in two thirds of IXT patients. NPA and visual acuity was normal in majority of cases. Stereoacuity was found better at near than at distance.

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