Diagnosis and management of divergence weakness in adults.
OBJECTIVE
To determine how frequently neurologic disease accompanies divergence weakness, the stability of the eye movement disorder, and the response to treatment.


METHODS
Prospective, interventional, noncomparative case series.


METHODS
Seventeen consecutive adult patients (28-96 years of age) with divergence weakness were prospectively evaluated from 1991 to 1997.


METHODS
Ocular alignment was measured at distance and near and in up, down, left, and right gaze. Fusional divergence amplitudes were measured at distance. The presence or absence of associated neurologic disease was noted. The response to treatment (prisms or strabismus surgery or both) was recorded.


RESULTS
None of the patients had concurrent neurologic disease. Thirteen patients remained stable, 3 improved, and 1 progressed. Sixteen patients were treated successfully: 12 with prisms and 4 with strabismus surgery; 1 patient was not treated.


CONCLUSIONS
Divergence weakness is usually an isolated condition that tends to remain stable and respond to treatment with either prisms or strabismus surgery.
Asheville Eye Medical and Surgical Associates, North Carolina 28801, USA.
R E
RE
Wiggins
S
S
Baumgartner
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004948:Esotropia / Q000175:diagnosis* / Q000628:therapy*; D005133:Eye Movements; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000473:pathology* / Q000601:surgery; D013508:Ophthalmologic Surgical Procedures; D009988:Orthoptics / Q000379:methods; D011446:Prospective Studies