Kushner B J
Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, USA.
Arch Ophthalmol. 1995 Jul;113(7):896-9. doi: 10.1001/archopht.1995.01100070070027.
To present guidelines for the diagnosis and management of fixation switch diplopia.
Adults with a history of strabismus since childhood may experience acquired diplopia if a change in their refractive error or use of spectacles encourages fixation with their nondominant eye. This is referred to as "fixation switch diplopia." If correctly diagnosed, this seldom-recognized cause of acquired diplopia in adults can almost always be successfully treated with the proper optical management.
A retrospective review was carried out for all patients with the diagnosis of fixation switch diplopia who were seen in my private practice.
A review of patient records identified 16 patients with fixation switch diplopia. In four patients, the switch in fixation was spontaneous owing to the development of myopia in the previously preferred eye in patients with mild contralateral amblyopia. Six patients developed diplopia owing to their "monovision" (one eye optically corrected for distance and the other eye presbyopic). In six patients, fixation switch diplopia occurred because a noncycloplegic subjective refraction was performed in the presence of amblyopia, resulting in an unbalanced refractive correction. In all 16 patients, symptoms were eliminated when proper optical correction was instituted to encourage fixation with the dominant eye.
Fixation switch diplopia is a cause of acquired diplopia in adults with a history of strabismus since childhood. It can usually be successfully treated with proper optical management.
提出固定转换性复视的诊断和处理指南。
自幼患有斜视的成年人，如果其屈光不正发生变化或佩戴眼镜促使其用非优势眼注视，可能会出现后天性复视。这被称为“固定转换性复视”。如果诊断正确，这种在成年人中较少被认识到的后天性复视原因几乎总能通过适当的光学处理成功治疗。
对在我的私人诊所就诊的所有诊断为固定转换性复视的患者进行了回顾性研究。
回顾患者记录发现16例固定转换性复视患者。4例患者中，由于轻度对侧弱视患者先前优势眼出现近视，注视发生自发性转换。6例患者因“单眼视”（一只眼睛进行远视力光学矫正，另一只眼睛矫正老视）而出现复视。6例患者中，由于在弱视存在的情况下进行了非睫状肌麻痹主观验光，导致屈光矫正不平衡，从而发生固定转换性复视。在所有16例患者中，当采用适当的光学矫正以促使优势眼注视时，症状均得以消除。
固定转换性复视是自幼患有斜视的成年人后天性复视的一个原因。通常通过适当的光学处理可成功治疗。
