Monofixation syndrome is a form of subnormal binocular vision characterized by small-angle strabismus, unilateral absolute facultative central suppression scotoma of less than 3 degrees, and peripheral fusion. It can be caused by conditions that surgically corrected strabismus, anisometropia, macular lesions, or a lack of symptoms. Diagnosis involves tests showing subnormal stereopsis, visual acuity differences between eyes, amblyopia, or retinal disease. Treatment may include amblyopia treatment, strabismus surgery, and follow-up care.

1. Monofixation syndrome
By- Raju Rathore
ITM UNIVERSITY RAIPUR

2. - Monofixation syndrome, defined by Marshall
M. Parks in 1969
- It is a form of subnormal binocular vision
without bifixation characterized by small-angle
strabismus, unilateral absolute facultative
central suppression scotoma of less than 3º,
and peripheral fusion
- Conditions that cause a suppression scotoma
in the central retina but allow for peripheral
fusion cause monofixation syndrome

4. Etiology
- Surgically corrected strabismus
- Anisometropia
- Macular lesion
- Primary- lack of symptoms

6. Diagnosis
- Subnormal steropsis
- Asymmetry in best corrected - visual acuity
- Anisometropia
- History of strabismus surgery
- Amblyopia
- Retinal disease

7. Diagnostic procedures
- Prism cover tests – less than 8 prism diopters of
heterotropia in cover/uncover test
- Stereoacuity tests – reduced stereopsis
- Worth-4-dot– Near: 4 lights, Distance: 2-3 lights
depending on the eye with the scotoma
- 4-Prism diopter base out test
- Bagolini lenses

8. Management
- Amblypia treatment (patching or penalization
- strabismus surgery
- follow-up

9. https://eyewiki.aao.org/Monofixation_syndrome