Purpose: intended for intermittent exotropia, is designed to provide: (1) successful vision training and a test method of a new concept in binocular examination through both the evaluation of binocular proprioception ability after vision training, and the analysis of a correlation between objective symptoms and subjective symptoms according to proprioception; and (2) fundamental data for accurate treatment and prognosis judgment for intermittent exotropia.
Methods: we newly designed Maindot test and observed the changes in binocular functions and subjective symptoms (diplopia appearance frequency) before and after vision training, and for a year after vision training, intended for orthophoric (N=14) and intermittent exotropia, in order to evaluate the suitability of binocular proprioception test by using Maindot test.
And based on the above-mentioned study, Maindot test was conducted, before vision training, on another 35 participants with intermittent exotropia complaining subjective symptoms such as diplopia, and whether or not to treat with vision training was determined in accordance with the results from examination of deviation rate and positive relative convergence (break point).
And then, we monitored, by tracking and observing, subjective symptoms according to binocular proprioception ability and objective symptoms after vision training and for 3 years after the completion of vision training.
Results: The results indicated that the status of binocular sense of intermittent exotropia patients (N=19) who carried out vision training sincerely in intermittent exotropia patients (N=22) was found to be similar to or better than that of orthophoric patients (N=14) in comparison group in terms of improved binocular motor function, binocular sense function and subjective symptoms (diplopia) after 10 weeks of vision training (p<0.001). and also the improved proprioception function by vision training was maintained for 6 months or a year after the completion of vision training.
And the results showed a correlation that as resulting value from Maindot test increased, deviation rate decreased; positive relative convergence (break point) increased; and subjective symptoms decreased on vision training of another 35 participants with intermittent exotropia (p<0.001).
also, it showed a correlation that subjective symptoms decreased as binocular proprioception ability changed (p<0.001).
However, there was found to be no significant correlation between binocular motor function, which is same as the values of changed deviation rate and positive relative convergence (break point), and subjective symptoms (p>0.05).
Conclusions: since the ultimate goal of vision training for intermittent exotropia is the improvement of binocular sense function to provide comfortableness in life with bonocular vision like orthophoric, the Maindot test for binocular proprioception ability that is correlated with subjective symptoms is expected to provide testers with very useful information on determination of whether or not vision training is successful, prognosis, and prediction of subjective symptoms.