Thomas R, Braganza A, George T
Schell Eye Hospital, Christian Medical College, Vellore, TamilNadu.
Indian J Ophthalmol. 1996 Jun;44(2):103-12.
Jampolsky's approach to the diagnosis of strabismus is simple. Certain tests are to be performed in sequence to determine 1) the presence of fusion in the habitual head position under normal viewing conditions and in the primary position at near and distance; 2) the presence and characteristics of fusion vergences and 3) the deviations that exist at distance and near. These are established by the cover tests and the prism cover test. 4) Incomitance of the strabismus, A-V phenomena and mechanical weaknesses and restrictions are assessed by observations of eye movements and the forceps tests. Finally, 5) inferences about the state of the sensory system are made based on the history, vision and clinical examination. Additional tests performed on indication are the 4 diopter prism test, the prism adaptation test and the forceps muscle tests. This approach allows an accurate and reproducible examination to be performed in an objective manner making it possible to compare clinical findings over time and allow a rational plan of management to be evolved. Errors in examination arise from poor control of three factors, accommodation, fixation and fusion vergence. These can be controlled by careful attention to the test conditions. This system of diagnosis is simple to follow and understand, economic on time and altogether less of a strain to examiner (and patient) than the traditional system.
詹波尔斯基的斜视诊断方法很简单。需要依次进行某些检查，以确定：1）在正常观察条件下，在习惯性头位以及在近、远距离的初始位置时融合功能是否存在；2）融合性聚散的存在及其特点；3）远、近距离存在的斜视度。这些通过遮盖试验和三棱镜遮盖试验来确定。4）通过观察眼球运动和镊子试验评估斜视的非共同性、A-V现象以及机械性弱点和限制。最后，5）根据病史、视力和临床检查对感觉系统的状态进行推断。根据指征进行的其他检查包括4棱镜试验、棱镜适应试验和镊子肌肉试验。这种方法能够以客观的方式进行准确且可重复的检查，从而能够比较不同时间的临床发现，并制定合理的治疗方案。检查中的误差源于对三个因素（调节、注视和融合性聚散）控制不佳。通过仔细关注检查条件可以对这些因素进行控制。这种诊断系统易于遵循和理解，节省时间，并且与传统系统相比，对检查者（和患者）来说压力更小。
