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We evaluated the outcome of orthoptic training for 296 patients with acquired ocular movement disorders (AOMD) over 23 years. We analyzed the sites of disturbance and the causes of the AOMD, and studied factors effecting indications for orthoptic training and prognosis . Out of 296 patients, 132 (45%) made category I recoveries, achieving fusional areas of over 30 degrees , and 131 patients (44%) made category II recoveries , achieving fusional areas of under 30 degrees. By site of disturbance, category I recoveries were made by 62% of patients with trochlear nerve palsy , by 52% of patients with abducens nerve palsy and by 33% of patients with oculomotor nerve palsy . By cause, category I recoveries were made by 60% of patients with vascular disorders , and by 43% of patients with head traumas. The most frequent cause of oculomotor nerve palsy and trochlear nerve palsy was found to be head trauma , and the second most frequent cause, vasclar disorders. The group with head trauma resulting in oculomotor nerve palsy did not make good recoveries . Most patients with oculomotor nerve, palsy developed total palsy in addition to brain injury , and half of the group exhibited aberrant regeneration because of a late start to the 6 months of orthoptic training. In the group with trochlear nerve palsy caused by head trauma was mild in severity , and the number of cases of brain injury were few . This group achieved a high degree of recovery within the 6 months of orthoptic training. We confirmed the role of detailed analysis of disease , and the importance of early orthoptic training in achieving good results from orthoptic training .

Orthoptic Training for Acquired Ocular Movement Disorders. II. Variance in Results According to Cause.