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Dvd
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2. DVD
Dissociated deviation )DD( manifests as a slow,
intermittent, and variable vertical )DVD(, horizontal
)DHD(, and torsional )DTD(.movement
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;
DVD neither disappears nor improves over
time
the aim of treatment is to obtain a latent
.deviation
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DD have three components. vertical )DVD(, horizontal
.)DHD(, and torsional )DTD( movements
Surgical plan requires taking into account the three
components and must be tailored to treat each
.particular case
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Dissociated horizontal deviation )DHD(: The main
diagnostic sign of DHD is the presence of a horizontal
deviation, esotropia )ET(, or exotropia )XT( that
changes with fixation of each eye, unrelated to
different accommodation, muscle weakness, or
.restriction
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Dissociated torsional deviation )DTD(: Children with
DD frequently have head turn but they also have head
tilt. The head tilt can be toward the shoulder of the
fixing eye )direct tilt( or toward the contralateral side
)inverse tilt(. We have to take into account the head
tilt to attempt to improve the head position when
.performing surgery
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Surgical Treatment
Symmetric DVD with Good Bilateral Visual Acuity, with No-1
Oblique Muscles Dysfunction
Bilateral DVD with Deep Unilateral Amblyopia-2
DVD with Inferior Oblique Overaction )I00A( and V Pattern -3
Symmetric vs. Asymmetric Surgeries for DVD-4
DVD with Hypotropiaof the Nonfixating Eye-5
6-DVD with Superior Oblique Overaction )SOOA( and A Pattern
