DVD- Dissociated Vertical Deviation

[gibby2020]

Hello Optiboarders!!

I havent seen any BV posts so here's one:

I have a healthy young lady (26 yr old) with double hyperphoria and exophoria on alt. cover test, at distance > near. She is non strabismic in all fields of gaze and exhibits a V pattern wrt the exophoria.
There is no refractive error. and her amplitudes of accommodation are good.

I'm bringing her back to do vergence testing distance and near, accommodative facility, fixation disparity testing and cyclo refraction.

Her c.c. is asthenopia at the end of day at work (car dealership's service desk).

Any experience out there dealing with this???

Thanks in advance
Gibby

[optimensch]

no experience that I can remember.
The V pattern would suggest that in theory, maybe some yoked (not yolked) BUp prism might help, but that is just an educated guess.

[gibby2020]

Thanks mensch
I should look around the net to see if there's a bv forum.
I've run across this in px's who have had strab surgery but not in a non strab !?

I'll see what her PFV's are in primary and up gaze vs the phoria and maybe rx horiz prism for that?? Any reliable test to determine if to rx prism, eg fixation disparity?? Same for the vertical component do vv's to see if they are imbalanced?

Gib

[optimensch]

hmmm. horiz. prism is a tough choice to make. How big is that exophoria? Excess divergence EXO but is it easily compensated? If it is easily compensated, no diplopia, really tough choice. like 1 BIn or something very small maybe.