25:
226:
DVD is often mistaken for over-action of the inferior oblique extra-ocular muscles. DVD can be revealed on ocular movement testing when one eye is occluded by the nose on lateral gaze. This eye will then elevate, simulating an inferior oblique over action. However, in a unilateral case, overaction of
206:
The patient is asked to look at a light. One eye is covered and a filter is placed in front of the other eye. The density or opacity of this filter is gradually increased, and the behaviour of the eye under the cover (not of the eye beneath the filter) is observed. Initially, if DVD is present, the
246:
Several different surgical procedures exist for the correction of DVD including: inferior oblique anteriorization, inferior oblique anteriorization plus resection, superior rectus recession, superior rectus recession plus posterior fixation suture, and inferior oblique myectomy, though there is
160:
DVDs are usually controlled from occurring with both eyes open, but may become manifest with inattention. Usually some level of dissociative occlusion is required to trigger the brain to suppress vision in that eye and then not control a DVD from occurring. The level of dissociative occlusion
169:
DVD typically becomes apparent between 18 months and three years of age; however, the difficulties of achieving the prolonged occlusion required for accurate detection in the very young make it possible that onset is generally earlier than these figures suggest.
193:
The dissociative movement seen 'objectively' should not be confused with the dissociation that occurs 'subjectively' – as when the brain begins to not visualise both images simultaneously (by ignoring or suppressing vision in that eye).
202:
A test called the
Bielschowsky Darkening Wedge Test can be used to reveal and diagnose the presence of dissociated vertical deviation, although any (or no) amount of dissociative occlusion may also prompt it to occur.
144:
The eye drifts upward spontaneously or after being covered. The condition usually affects both eyes, but can occur unilaterally or asymmetrically. It is often associated with latent or manifest-latent
178:
Dissociation refers to the situation where the innervation of one eye causes it to move involuntarily and independently of the other eye. Usually both eyes work together as described by
42:
183:
190:
of the vision in that eye while it is deviated. On returning downward and possibly inward to take up fixation, the DVD slow movement will be reversed.
364:
89:
61:
179:
218:
The
Bielschowsky phenomenon is also present in the horizontal plane in patients with prominent DHD (dissociated horizontal deviation).
302:
68:
108:
207:
covered eye will have elevated, but as the filter opacity is increased the eye under the cover will gradually move downwards. This
227:
the superior rectus muscle in the unaffected dominant eye, can also be a causing factor as well as causing a V pattern exophoria.
75:
46:
57:
35:
136:. The exact cause is unknown, although it is logical to assume it is from faulty innervation of eye muscles.
261:
240:
82:
236:
464:
186:
laws of innervation. A DVD is a slow upward and sometimes temporal movement of one eye, with cortical
256:
161:
required may involve using a red filter, a darker filter or complete occlusion (e.g. with a hand).
150:
133:
271:
211:
is present in over 50% of persons with prominent DVD, all the more if the DVD is asymmetric and
411:
360:
327:
298:
247:
insufficient evidence to determine which procedure results in the best outcomes for patients.
187:
354:
235:
Management of this condition is surgical and typically involves reducing the strength of the
401:
393:
406:
381:
458:
397:
24:
319:
266:
129:
212:
154:
146:
415:
331:
18:
128:) is an eye condition which occurs in association with a
431:
Diagnosis and management of ocular motility disorders
297:(17th ed.). McGraw-Hill Medical. p. 246.
49:. Unsourced material may be challenged and removed.
382:"Interventions for dissociated vertical deviation"
356:Strabismus Surgery: Basic and Advanced Strategies
293:John P.Whitcher; Paul Riordan-Eva (2007-10-18).
326:, Treasure Island (FL): StatPearls Publishing,
8:
348:
346:
295:Vaughan & Asbury's general ophthalmology
405:
318:Kaur, Kirandeep; Gurnani, Bharat (2022),
288:
286:
109:Learn how and when to remove this message
359:. Oxford University Press. p. 76.
282:
7:
153:, can also be found associated with
47:adding citations to reliable sources
380:Hatt SR, Wang X, Holmes JM (2015).
14:
239:or anterior transposition of the
320:"Dissociated Vertical Deviation"
58:"Dissociated vertical deviation"
23:
149:and, as well as occurring with
34:needs additional citations for
398:10.1002/14651858.CD010868.pub2
122:Dissociated vertical deviation
1:
481:
448:(2nd ed.). Blackwell.
433:(2nd ed.). Blackwell.
429:Mein J, Trimble R (1991).
386:Cochrane Database Syst Rev
157:and vertical deviations.
353:David A. Plager (2004).
262:Pediatric ophthalmology
241:inferior oblique muscle
209:Bielschowsky phenomenon
243:of the affected eyes.
237:superior rectus muscle
222:Differential diagnosis
16:Eye medical condition
215:is present as well.
43:improve this article
446:Clinical Orthoptics
257:Infantile esotropia
151:infantile esotropia
134:infantile esotropia
272:Strabismus surgery
366:978-0-19-517023-8
119:
118:
111:
93:
472:
450:
449:
441:
435:
434:
426:
420:
419:
409:
392:(11): CD010868.
377:
371:
370:
350:
341:
340:
339:
338:
315:
309:
308:
290:
114:
107:
103:
100:
94:
92:
51:
27:
19:
480:
479:
475:
474:
473:
471:
470:
469:
455:
454:
453:
444:F Rowe (2004).
443:
442:
438:
428:
427:
423:
379:
378:
374:
367:
352:
351:
344:
336:
334:
317:
316:
312:
305:
292:
291:
284:
280:
253:
233:
224:
200:
176:
167:
142:
115:
104:
98:
95:
52:
50:
40:
28:
17:
12:
11:
5:
478:
476:
468:
467:
457:
456:
452:
451:
436:
421:
372:
365:
342:
310:
304:978-0071443142
303:
281:
279:
276:
275:
274:
269:
264:
259:
252:
249:
232:
229:
223:
220:
199:
196:
175:
172:
166:
163:
141:
138:
117:
116:
31:
29:
22:
15:
13:
10:
9:
6:
4:
3:
2:
477:
466:
463:
462:
460:
447:
440:
437:
432:
425:
422:
417:
413:
408:
403:
399:
395:
391:
387:
383:
376:
373:
368:
362:
358:
357:
349:
347:
343:
333:
329:
325:
321:
314:
311:
306:
300:
296:
289:
287:
283:
277:
273:
270:
268:
265:
263:
260:
258:
255:
254:
250:
248:
244:
242:
238:
230:
228:
221:
219:
216:
214:
210:
204:
197:
195:
191:
189:
185:
184:Sherrington's
181:
173:
171:
164:
162:
158:
156:
152:
148:
139:
137:
135:
131:
127:
123:
113:
110:
102:
91:
88:
84:
81:
77:
74:
70:
67:
63:
60: –
59:
55:
54:Find sources:
48:
44:
38:
37:
32:This article
30:
26:
21:
20:
465:Eye diseases
445:
439:
430:
424:
389:
385:
375:
355:
335:, retrieved
323:
313:
294:
245:
234:
225:
217:
208:
205:
201:
192:
177:
168:
159:
143:
140:Presentation
132:, typically
125:
121:
120:
105:
99:January 2019
96:
86:
79:
72:
65:
53:
41:Please help
36:verification
33:
188:suppression
337:2022-10-24
324:StatPearls
278:References
267:Strabismus
155:exotropias
69:newspapers
231:Treatment
213:amblyopia
198:Diagnosis
174:Mechanism
147:nystagmus
459:Category
416:26587695
332:34424634
251:See also
180:Hering's
407:4710857
83:scholar
414:
404:
363:
330:
301:
130:squint
85:
78:
71:
64:
56:
165:Onset
90:JSTOR
76:books
412:PMID
361:ISBN
328:PMID
299:ISBN
182:and
62:news
402:PMC
394:doi
126:DVD
45:by
461::
410:.
400:.
390:11
388:.
384:.
345:^
322:,
285:^
418:.
396::
369:.
307:.
124:(
112:)
106:(
101:)
97:(
87:·
80:·
73:·
66:·
39:.
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
