Hypertropia

Hypertropia, commonly called vertical strabismus, wandering eye or wall-eye, is the visual condition in which a person uses only one eye to look at an object while the other eye turns upward. Hypertropia is one of several types of strabismus, a condition resulting in eye turns or deviating eyes. Eye coordination in a patient with hypertropia may not be developed enough to provide normal control of his or her binocular vision.


Functional treatment and cosmetic treatment

Treatment for hypertropia should be both cosmetic (making the eyes look more straight) and functional (making the eyes function properly as a team - this is called binocular vision).

Our two eyes work together as a binocular system. When our two eyes work together well, we can easily and efficiently measure the location of objects in relation to ourselves. Binocular vision makes it easier for us to ride a bicycle, drive a car, or direct many other daily activities.

An eye that wanders is much more than just an appearance problem. For example, reading demands accurate binocular vision. When a person's eyes do not aim at the same place accurately and simultaneously, he or she will have much more difficulty with large amounts of reading, writing, and other close work.

Treatment of Hypertropia

Treatments for hypertropia involve the use of lenses and vision therapy. Sometimes surgery is required. Patching one eye may also make the person more aware of the eye that is misused. Our doctors thoroughly evaluate this condition and provide treatment options, including non-surgical vision therapy or surgery if it is warranted.

A recent study published in the journal Optometry & Visual Performance look at vision therapy treatment of a a 12-year old girl who had hypertropia and exotropia at the same time. This caused double vision and an head-tilt. The study demonstrated treatment with spectacles using specially designed prism lenses to immediately provide relief of symptoms followed by a program of vision therapy that lasted six months and a gradual removal of prism from the spectacle lenses.

The results were excellent. At the one year follow-up, the patient no longer needed prism spectacles and remained asymptomatic. The vertical deviation of her eye was zero after treatment.

The authors of the study concluded that :

Vision therapy for vertical deviations may not be the primary treatment option due to the multitude of challenges it poses for many patients and clinicians. This report details a highly motivated patient who was successfully managed with VT and no longer needs prism compensation. Even though treatment may be lengthy and demanding for all involved parties, VT remains a viable, and sometimes the best, treatment option for long-term success.

 

 


The most famous vision therapy patient is neuroscientist, Susan Barry, who had strabismus.

"Today, a relatively small group of optometrists still practice and continue to perfect optometric vision therapy techniques.  Yet, it is difficult for a strabismic patient to learn about, much less access, this type of clinician."

Dr. Susan Barry, 2010 Journal of the American Optometric Association 

 

Susan Barry on Vision therapy.

Neuroscientist (and adult vision therapy success story) Dr. Susan Barry gives a TED Talk about strabismus, depth perception and vision therapy: