Measuring Divergence Amplitude

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Identifier Divergence_Amplitude_NOVEL
Title Measuring Divergence Amplitude
Subject Insufficient Divergence
Creator Tony Brune, DO, Department of Neurology, The Johns Hopkins School of Medicine; Daniel R. Gold, DO, Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine
Description Divergence insufficiency should be suspected in patients with binocular horizontal diplopia at distance (but not near) who lack abduction deficits. There should be an esodeviation greater at distance, and in older patients with levator dehiscence (or previous ptosis surgery) and prominent superior sulci, the so-called ‘sagging eye syndrome' should be considered. Divergence insufficiency may also be associated with cerebellar (or other neurologic) disease, so a complete ocular motor and neurologic exam is necessary. ; Patients with divergence insufficiency will have a poor divergence amplitude - that is, when the patient views a target at distance (if diplopia is not experienced to begin with), even a small amount of base-in prism will cause doubling of the target, also known as the ‘break point'. Although there are no universally-accepted normative values for divergence amplitude, the inability to fuse even a small amount of base-in prism at distance (e.g., 1 prism diopter) is generally considered abnormal, especially in patients with complaints suggestive of divergence insufficiency.
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2018-06
Format video/mp4
Rights Management Copyright 2018. For further information regarding the rights to this collection, please visit:
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s66d9xht
Setname ehsl_novel_gold
Date Created 2018-06-05
Date Modified 2018-08-01
ID 1340104
Reference URL
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