NeuroVisual Medicine Institute, Bloomfield Hills.
St. Joseph Mercy Hospital, Ypsilanti.
Otol Neurotol. 2021 Jan;42(1):e66-e74. doi: 10.1097/MAO.0000000000002874.
Among patients presenting with dizziness, visual dysfunction must be considered, including vertical heterophoria (VH), a frequently under-identified form of binocular vision dysfunction where there is vertical discrepancy between the lines of sight of the eyes when at physiologic rest. Current self-rated screening measures do not account for complex VH symptomatology including dizziness/ambulation difficulties, nausea, headache, anxiety, neck pain, and reading impairment. VH must be differentiated from vestibular/otolithic etiologies, as their treatment frequently provides inadequate relief, yet treatment of the VH can reduce/eliminate symptoms. The objective of this study is to create a valid measurement tool (binocular vision dysfunction questionnaire) to assist in identifying VH among dizzy patients to aid in appropriate referral.
Retrospective case series.
Tertiary referral center.
One hundred twenty-six patients presenting to an optometric binocular vision subspecialist diagnosed with VH.
Psychometric study. The measurement tool's internal consistency and test-retest reliability was assessed. Confirmatory and exploratory factor analyses were performed. Validity was estimated through correlations with a visual analog scale and validated instruments for headaches, dizziness, and anxiety.
MAIN OUTCOME MEASURES/RESULTS: Excellent reliability demonstrated including Cronbach's alpha of 0.91 and high test-retest reliability. Statistical correlations with established measurements established sound convergent/content validity. Analysis of participants who underwent treatment indicated change in BVDQ score correlates with perception of change in symptom burden.
Results suggest the BVDQ is a valid, reliable screening tool to assist otologists in identifying VH among their dizzy patients. The BVDQ may also be useful for measuring changes with various treatments, and in identifying diverse symptoms associated with BVD/VH.
在出现头晕的患者中，必须考虑视觉功能障碍，包括垂直性隐斜视（VH），这是一种经常被低估的双眼视觉功能障碍形式，即当眼睛处于生理静止时，视线之间存在垂直差异。目前的自我评估筛查措施并未考虑包括头晕/行走困难、恶心、头痛、焦虑、颈部疼痛和阅读障碍在内的复杂 VH 症状。VH 必须与前庭/耳石症病因区分开来，因为它们的治疗常常不能充分缓解症状，但 VH 的治疗可以减轻/消除症状。本研究的目的是创建一个有效的测量工具（双眼视觉功能障碍问卷），以帮助识别头晕患者中的 VH，从而进行适当的转诊。
回顾性病例系列。
三级转诊中心。
126 名因 VH 就诊于视光学双眼视觉专科医生的患者。
心理测量研究。评估了测量工具的内部一致性和重测信度。进行了验证性和探索性因子分析。通过与视觉模拟评分和用于头痛、头晕和焦虑的已验证仪器的相关性来评估有效性。
结果显示，该测量工具具有极好的可靠性，包括 Cronbach's alpha 为 0.91 和高重测信度。与已建立的测量方法的统计相关性表明具有良好的收敛/内容有效性。对接受治疗的参与者进行分析表明，BVDQ 评分的变化与症状负担变化的感知相关。
结果表明，BVDQ 是一种有效、可靠的筛查工具，可帮助耳科医生在其头晕患者中识别 VH。BVDQ 也可能有助于测量各种治疗方法的变化，并识别与 BVD/VH 相关的各种症状。
