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Strabismus in hemianopia
Investigator (PI): Bronstad, Philip Matthew
Performing Organization (PO): (Current): Massachusetts Eye and Ear, Schepens Eye Research Institute / (617) 573-3523
Supporting Agency (SA): National Institutes of Health (NIH), National Eye Institute (NEI)
Initial Year: 2015
Final Year: 2018
Record Source/Award ID: RePorter/R01EY024084
Funding: Total Award Amount: $1,484,474
2015 Award Amount: $510,822
2016 Award Amount: $486,826
2017 Award Amount: $486,826
Award Type: Grant
Award Information: Reports resulting from this project
Abstract: Homonymous hemianopia (HH) is vision loss in one half of the visual field due to stroke, head trauma, or tumor. Strabismus, misalignment of the eyes, is present with HH 10 times more often than expected. Strabismus may compensate for HH if the deviant eye points into the blind hemi-field and if harmonious anomalous retinal correspondence (HARC) has also developed; however, there is no data showing whether the compensation gives any advantage to the child who develops both visual impairments. We will conduct a retrospective study of a large population of children who have both strabismus and hemianopia. Previous publications have only examined, at most, four cases, and have not measured any effect of the condition on mobility. We have identified 119 patients who have both impairments at Boston Children's Hospital. Thus, this will be the largest study of its kind and have a positive impact on pediatric health care, regardless of outcome. Moreover, it suggests that this combination of visual impairments is not as rare as assumed. Worldwide there may be one hundred thousand children with both visual impairments. We will measure visual functioning in these patients (retinal correspondence and suppression in central and peripheral visual field, binocular vision, diplopia, and visual field extent) and mobility with regards to hazard detection in driving and obstacle avoidance in walking. This will allow us to determine whether strabismus offers any advantage in children with HH. We will also use prism correction to measure the potential effect of strabismus surgery in these participants. To understand the long-term effects of strabismus surgery, we will examine the subset of 24 patients in this population who have had strabismus surgery. These participants will be tested to discover whether prism glasses can restore HARC while permitting the benefits of surgery. Such a treatment would allow children to enjoy the benefits of surgery as well as any mobility improvements we observed. It may also allow such patients to pass driving license requirements, which is important in many countries throughout the world.
MeSH Terms:
  • Boston
  • Child
  • Health Services Research
  • Humans
  • Outcome Assessment, Health Care
  • Retina /physiology
  • Retrospective Studies
  • Strabismus /*complications
  • /surgery
  • Vision Disorders /*complications
  • Walking
Keywords:
  • Boston
  • activities of daily living
  • automobile driving
  • binocular vision
  • child
  • childhood
  • diplopia
  • esotropia
  • eye
  • hemianopsia
  • homonymous hemianopia
  • long-term effects
  • operative surgical procedures
  • pediatric hospitals
  • peripheral
  • strabismus
  • visual impairment
Country: United States
State: Massachusetts
Zip Code: 02114
UI: 20161034
Project Status: Completed