The Effect of Conservative Therapy on Diplopia in Patients with Paralytic Strabismus

Aim: To evaluate efficacy of pleoptic and orthoptic therapy combined with a home rehabilitation program with a support of a specifically-developed software in patients with ocular motility disorder and diplopia, Methods: Our study involved 86 adult patients with ocular motility disorder and diplopia (33 with rehabilitation a study group, 53 without any rehabilitation a control group). The causes of ocular motility disorders included cerebrovascular accident, craniocerebral trauma and vascular disease. A comprehensive ophthalmological and orthoptic examination were performed in all patients. The Hess-Lancaster screen tests were performed to objectify ocular motility disorder with diplopia. Follow-up period ranged between 3 and 6 months in both groups. Results: The mean improvement of horizontal deviation in patients with the sixth cranial nerve palsy on one eye was 96.8% in the study group (p <= 0.01) and 28.2% in the control group (p <= 0.00001), and it was 73.7% in the study group (p <= 0.0008), 36.3% in the control group (p <= 0.05) in patients with the third and fourth cranial nerve palsy on one eye. The mean improvement of vertical deviation was 43.5% in the study group (p <= 0.002), 19.9% in the control group (p <= 0.04). Conclusion:This study demonstrates greater improvement of deviation and ocular motility deficit in adult patients who underwent the pleoptic and orthoptic therapy combined with a home rehabilitation program.