• Journal of Korean Ophthalmic Optics Society
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• v.15 no.2
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• pp.155-160
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• 2010

Purpose: The purpose of this study was to evaluate how phoria variations would vary with head positions, as well as to review the need to differentiate prism placement over either eye in a relation to the imbalance of the extraocular muscle. Methods: This study was carried out with 44 males (88 eyes) and 16 females (32 eyes) aged between 20 and 30. For all subjects, testings were performed using cover test, subjective refraction, phoria and vergence test. To analyze phoria variations comparatively for the head tilt test and the face turn test, phoria deviation were measured using the von Graefe. Results: For the phoria variation related with head tilt and face turn, a significant difference was observed in the group judged to be abnormal on the horizontal phoria of Morgan' norm (p<0.05); especially in patients who needed near prescription of Sheard's criterion, a higher variation was observed (p<0.05). The abnormal group was composed of patients who needed distance prescription of Sheard's criterion and ones who did not need the prescription, all of whom showed phoria variations, but the mean value was less than the near. Conclusions: With regard to the head tilt and face turn related phoria level, the patients who needed near horizontal prism prescription of Sheard's criterion showed a remarkably higher variation. Altogether, it is deemed to check whether extraocular muscles are ill-balanced in both eyes previously to determine the prism power on phoria level to the end that each of prism powers may be accurately determined.

• Journal of Korean Ophthalmic Optics Society
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• v.21 no.3
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• pp.235-242
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• 2016

Purpose: This study was to investigate whether the application of different diagnostic criteria affected the frequency of convergence insufficiency (CI). Methods: Eighty one subjects with mean age of 22.54 years (20 to 27 years) were evaluated. Binocularity tests after refraction were performed as the following tests: near point of convergence (NPC) with an accommodative target, phoria using von Graefe method, positive fusional vergence (PFV) with a phoropter. Subjects with CI were diagnosed when exophoria (exo) was greater at near than at distance ($exo{\geq}4{\Delta}$, or >$6{\Delta}$), fusional vergence was $PFV{\leq}11{\Delta}$ for blur, $PFV{\leq}15{\Delta}$ for break, Sheard's or Percival's criterion, and NPC was $NPC{\geq}6cm$, ${\geq}7.5cm$ or >10 cm. Results: Frequency of CI with one diagnostic criterion was ranged from 6.2% to 77.8%, and was overestimated or underestimated according to criteria. It was reduced to the range of 6.2% to 43.2% with diagnostic criteria more than two, especially to the range of 24.7% to 28.4% with lower variability in diagnostic criteria including phoria and Sheard's criterion. There were high relationship between total score of signs and phoria score (r = 0.772, p<0.001), and measured phoria and Sheard's criterion (r = -0.654, p<0.001), but NPC had a high variability and a weak or no significant relationship with other diagnostic criteria. Results suggested $exo{\geq}4{\Delta}$, Sheard's criterion and $NPC{\geq}7.5cm$ for diagnostic criteria of signs and sequence for CI. Conclusions: Frequency of CI is likely to be over- and underestimated with diagnostic criteria. Cutoff values and procedures for phoria, Sheard's criterion and NPC as clinical signs should be suggested definitely in diagnosis associated with CI.

• Journal of Korean Ophthalmic Optics Society
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• v.11 no.3
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• pp.193-200
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• 2006

We investigated the visual analysis of the far distance phoria for 83 subjects who have emmetropia or myopia eyes, using the graphic method, and determined new norms. We got the following results from these experiments. 1. The measured norm of far distance phoria is $1.12{\Delta}$, exophoria, the that of near distance phoria is $0.50{\Delta}$, exophoria, the that of negative relative convergence at far distance(N.R.C.) is ${\times}$/11/5, the that of positive relative convergence at far distance(P.R.C.) is 10/20/8, the that negative relative convergence at near distance(N.R.C.) is 11/21/5, the that of positive relative convergence at near(P.R.C.) is 10/20/8, the that of negative relative accommodation(N.R.A.) is +2.54D, and the that of positive relative accommodation(P.R.A.) is -2.60D, respectively. We know from theses results that the measured norms of far distancet phoria is higher than Morgan's norms, while those of near distance phoria are lower than Morgan's norms. 2. We also know from these experiments that Morgan's norms are closely related to A, B, and C groups and Morgan's criterion can more usefully apply to the visual analysis. 3. In Sheard's criterion and Percival's criterion, the prism prescription is occurred when the exophoria of the far-point phoria is over $7{\sim}9{\Delta}$, and the esophoria of that is over $4{\sim}6{\Delta}$.

• Journal of Korean Ophthalmic Optics Society
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• v.14 no.3
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• pp.37-42
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• 2009

Purpose: There is uncertainty if the vergence facility would provide clinically significant supplementary information to the fusional vergence measurements. The purpose of this study was to determine the relationship between vergence facility and fusional vergence in a group of symptomatic subjects. Methods: A total of 114 symptomatic subjects aged 9 to 13 years, who passed the vision screening test, participated in this study. Vergence facility was measured with 8$\Delta$ BI/8$\Delta$ BO flipper lenses and a suppression control target, the 20/30 letter line on Vectogram 9 (Bernell, USA). Near fusional vergence was measured with a single 20/30 vertical line target by Von Graefe technique. In order to avoid excessive convergence stimulation, negative fusional vergence (NFV) range (blur, break and recovery) was measured followed by positive fusional vergence (PFV) ranges (blur, break and recovery). Results: Pearson correlations were calculated and showed no correlations between vergence facility and any of fusional vergence measurements (p>0.05). Also, there were no significant differences of vergence facility measurements on the compensating vergence that passed or failed Sheard and Morgan's criterion for comfortable vision (p>0.05). Conclusions: There was no correlation between vergence facility and fusional vergence among symptomatic subjects. Hence, both vergence facility and fusional vergence should be assessed for those with binocular dysfunction in order to make an accurate diagnosis and management plan.