Synoptophore inspection

The examination of synoptophore is that the examinee sits in front of the examination table and adjusts the height of the table and chin frame so that the eye and the lens tube are at the same height. Press the pupil distance and adjust the distance between the two lens tubes to make the lens tube face the eyes. Adjust the forehead frame and wear corrective glasses for ametropia.

Measurement of the angle of heterodynia


(1) Use simultaneous perceptual pictures such as lions and cages, goalkeepers and football doors, goldfish and fish tanks.


(2) Fixed at 0 degree, the strabismus lens tube is moved to the position consistent with the line of sight (i.e. facing the strabismus direction), and then the light source is switched on and off alternately. At the same time, the subjects are asked to fix their own pictures and observe whether the eyeball has horizontal movement. Adjust the strabismus glasses tube until the two eyes no longer move. At this time, the degree of strabismus glasses tube refers to the horizontal angle of vision. If the light source is switched alternately and the eyeball moves up and down, it is necessary to rotate the control button up and down to make the strabismus eye picture rise or fall until the two eyes no longer have up and down movement, then the vertical angle of heterodyne angle can be read from the scale.


(3) If the deviation of eye position is not common, the oblique angle of the other eye should be measured with fixed vision of two eyes respectively. The first oblique angle of strabismus eye measured by fixed vision of healthy eye is the second oblique angle. In addition, the horizontal oblique angles of 15 ° to 20 ° on the left and right should be measured when the two eyes were fixed separately. In case of non concomitant vertical strabismus, the vertical oblique angles of 15 ° up and down should be measured again.


(4) A, V or X phenomenon can be diagnosed by measuring the horizontal strabismus degree of 15 ° above and below the horizontal strabismus.


(5) If the strabismus eye is amblyopia and the fixation state is poor, the fixed eye of the subject can be fixed at 0 ° and the amblyopia eyeglass tube can be adjusted up and down to make the reflected light spot of the lens tube light source fall right at the center of the cornea of the amblyopia eye. At this time, the scale on the wall of the lens tube is the other angle of vision.


Measurement of conscious oblique angle of view


(1) Use simultaneous perception.


(2) Fix the fixed spectacle tube at 0 ° and let the examinee push and pull the handle of strabismus glasses tube until the lion is put into the cage. At this time, the scale of the lens tube wall is the horizontal conscious oblique angle. If one of the two images is higher than the other, it indicates that the opposite eye is inclined upward. You can turn the up and down buttons to make a picture rise or fall until they are at the same level. At this time, the scale on the cylinder is the up and down squint. If the examinee feels that the figure of a certain picture is inclined to a certain extent (it is better to use pictures with bottom line, such as lion and cage), it indicates that there is a rotation oblique position, and another group of rotary buttons can be turned to make the picture rotate. When the patient thinks that the picture has become horizontal, the rotation degree of the picture is the rotation squint.


(3) If the deviation of eye position is not common, the first and second oblique angle and the conscious oblique angle of 15 ° to 20 ° left and right and 15 ° up and down can be measured respectively.


(4) No matter how you turn the handle of the lens tube, the picture of the lion and the cage do not coincide. If the lion is always on one side of the cage, the oblique angle of view cannot be measured, indicating that the retina is missing.


(5) If the handle of the lens tube is rotated, the lion and the cage gradually approach, but suddenly jump to the opposite side, indicating that the intersection is like a coincidence point, but there is inhibition.


(6) If only one picture can be seen all the time, but no picture can be seen in the other eye, it is caused by a wide range of monocular inhibition, indicating that there is no simultaneous perception.


Measurement of retinal correspondence


Use simultaneous perception. The oblique angle of view and conscious oblique angle were measured. ① If the degrees of the two are equal, they are corresponding to the normal retina. If the difference is only 2-3 degrees, it can be regarded as normal retinal correspondence. ② If the conscious oblique angle is less than 5 ° than the other oblique angle, it is the abnormal retinal correspondence, and the difference between the two is the abnormal corresponding angle. When the abnormal corresponding angle is equal to the other oblique angle, that is, the conscious oblique angle is equal to 0, it is harmonious or consistent abnormal retinal correspondence. If the abnormal angle is smaller than that of the other oblique angle, that is, the abnormal angle of the conscious oblique angle is smaller than that of the other oblique angle, and there is still a certain degree of abnormal angle, it is the discordant or inconsistent abnormal retinal correspondence. ③ If the self-conscious strabismus angle can only be obtained from the intersection point, then the degree at the intersection point is exactly the same as that of the heterotropia angle, which is an attempt to correspond to the normal retina. If the degree of intersection is different from the angle of heterotropia, it is an attempt to abnormal retina.


Fusion and fusion range were measured


The fusion picture is a pair of similar pictures with control points. For example, the two pictures are the same kittens, but one cat has ears but no tail, and the other cat has tail but no ears. Ears and tail are control points.


Put the picture in the two lens tubes and let the examinee move the lens tube to make the two eye pictures coincide and have all the control points. For example, to become a kitten with ears and tail, this is fusion. Then tighten the control button to lock the two arms, so that the two arms can produce the same amount of direction, convergence (convergence) or separate rotation, until the two images no longer continue to coincide (two pictures separate or one eye control point disappears), the radius between the maximum spoke and the separation point is the fusion range. The normal range of fusion was 25 ° - 30 ° (children were slightly smaller), the separation was 4 ° - 6 ° and the vertical separation was 2 ° - 4 °.


Check stereopsis

With stereoscopic picture, that is a special kind of fusion picture, it is divided into eccentric picture and far and near picture. The eccentric picture can be a picture of two buckets, each with two circles inside and outside, two pieces of outer circle equal in size and connected with the same handle, while the two pictures of inner circle are equal in size, but one side of the picture is biased to the right and the other side to the left with the same distance. The far and near picture is composed of two pictures with the same but different parallax. During the examination, both eyes look at one picture at the same time. For example, when the two outer circles coincide, the inner circle is perceived by the non corresponding points of the retina of the two eyes. It is fused by the two eyes into a bucket with three-dimensional sense, indicating the existence of stereoscopic vision. Otherwise, there is no stereopsis.


In addition, the stereogram can also be used for stereopsis.


Kappa angle measurement


With a special picture, the film has a horizontal line, the center of which is 0, and the letters a, B, C, D are arranged equidistant to one side The numbers 1, 2, 3, 4 are arranged equidistant to the other side. Place the picture in the lens tube of one eye, and let the eye focus on 0 in the center of the picture. When the corneal reflection point of the lens tube is just in the center of the pupil, then its K angle is 0 °. If the corneal reflection point is on the nasal side of the corneal center, its K angle is positive. If the corneal reflection point is in the temporal side of the center of the cornea, the K angle is negative. For those with positive or negative K angle, let them focus on the letters or numbers on the picture in turn until the corneal reflection point moves to the center of pupil, and record the corresponding number, which is k angle degree.


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