Understanding whether disparity is used more than blur (or vice versa), and whether accommodation exceeds convergence (or vice versa) helps us understand why intermittent squint, heterophorias and convergence\/accommodative problems behave as they do<\/strong><\/li>\n<\/ul>\nPurpose<\/h2>\n
To propose an alternative and practical model to conceptualize clinical patterns of concomitant intermittent strabismus, heterophoria, and convergence and accommodation anomalies.<\/p>\n
Methods<\/h2>\n
Despite identical ratios, there can be a disparity- or blur-biased \u201cstyle\u201d in three hypothetical scenarios: normal; high ratio of accommodative convergence to accommodation (AC\/A) and low ratio of convergence accommodation to convergence (CA\/C); low AC\/A and high CA\/C. We calculated disparity bias indices (DBI) to reflect these biases and provide early objective data from small illustrative clinical groups that fit these styles.<\/p>\n
Results<\/h2>\n
Normal adults (n = 56) and children (n = 24) showed disparity bias (adult DBI 0.43 [95% CI, 0.50-0.36], child DBI 0.20 [95% CI, 0.31-0.07]; P = 0.001). Accommodative esotropia (n = 3) showed less disparity-bias (DBI 0.03). In the high AC\/A\u2013low CA\/C scenario, early presbyopia (n = 22) showed mean DBI of 0.17 (95% CI, 0.28-0.06), compared to DBI of \u22120.31 in convergence excess esotropia (n=8). In the low AC\/A\u2013high CA\/C scenario near exotropia (n = 17) showed mean DBI of 0.27. DBI ranged between 1.25 and \u22121.67.<\/p>\n
Conclusions<\/h2>\n
Establishing disparity or blur bias adds to AC\/A and CA\/C ratios to explain clinical patterns. Excessive bias or inflexibility in near-cue use increases risk of clinical problems.<\/p>\n","protected":false},"excerpt":{"rendered":"
Horwood A, Riddell P. 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