Wilson M E, McClatchey S K
Department of Ophthalmology, National Naval Medical Center, Bethesda, Md.
J Pediatr Ophthalmol Strabismus. 1991 Mar-Apr;28(2):90-5. doi: 10.3928/0191-3913-19910301-09.
Despite the emphasis placed on the vertical aspect of the deviation by its currently accepted clinical label, dissociated vertical deviation is well known to include movements in both the torsional and horizontal planes. When the horizontal component is very prominent, dissociated horizontal deviation is suggested as an appropriate label. We report the clinical characteristics and surgical treatment of six patients with a dissociated horizontal deviation that was marked enough to be the reason for seeking medical attention. All patients underwent lateral rectus recession unilaterally or bilaterally, alone or in combination with superior rectus recession. In addition, we report the use of the darkening wedge test to demonstrate the Bielschowsky phenomenon in the horizontal plane. This phenomenon, a dissociated exotropia spontaneously moving toward and crossing the midline to become an esotropia under cover when a progressively darkening filter is placed over the fixing eye, has not to our knowledge been previously reported.
尽管目前公认的临床名称强调了该斜视垂直方向的偏差，但众所周知，分离性垂直偏斜包括扭转和水平平面的运动。当水平分量非常突出时，建议使用分离性水平偏斜这一恰当名称。我们报告了6例分离性水平偏斜患者的临床特征及手术治疗情况，其偏斜程度足以成为就医原因。所有患者均接受了单侧或双侧外直肌后徙术，单独或联合上直肌后徙术。此外，我们报告了使用暗化楔形试验来证明水平面上的 Bielschowsky 现象。据我们所知，当在注视眼上放置逐渐变暗的滤光片时，这种现象，即分离性外斜视在遮盖下自发地向中线移动并越过中线变为内斜视，此前尚未见报道。
