Anomalous Retinal Correspondence

DEFINITION:

Anomalous correspondence is a cortical, visual adaptation to a strabismus existing when the visual direction of the fovea of one eye corresponds with the perceived visual direction of a non-foveal location of the fellow eye.

SIGNS AND SYMPTOMS:

The signs and symptoms associated with anomalous correspondence may include, but are not limited to, the following:

1. better than expected performance on tasks requiring binocular vision
2. post-surgical increase in the angle of deviation
3. absence of diplopia
4. avoids eye contact
5. avoidance of visually demanding tasks

DIAGNOSTIC FACTORS:

Anomalous correspondence is characterized by one or more of the following diagnostic findings:

1. characteristics of diplopia inconsistent with the magnitude and/or direction of the strabismus
2. significant difference between subjective and objective angle of squint.

THERAPEUTIC MANAGEMENT CONSIDERATIONS:

The doctor of optometry determines appropriate diagnostic and therapeutic modalities, and frequency of evaluation and follow-up, based on the urgency and nature of the patient’s conditions and unique needs. Vision disorders that are not totally cured through vision therapy may still be ameliorated with significant improvement in visual function and quality of life. The management of the case and duration of treatment would be affected by:

1. the severity of symptoms and diagnostic factors, including onset and duration of the problem
2. the complications of associated visual conditions
3. implications of patient’s general health, cognitive development, physical development, and effects of medications taken
4. etiological factors
5. extent of visual demands placed upon the individual
6. patient compliance and involvement in the prescribed therapy regimen
7. type, scope, and results of prior interventions
8. occupational/avocational goals

PRESCRIBED TREATMENT REGIMEN:

The treatment of anomalous correspondence requires optometric vision therapy, which incorporates the prescription of specific treatments in order to:

1. re-establish normal common spatial projection
2. habituate normal common spatial projection

DURATION OF TREATMENT:

Anomalous correspondence is an adaptation associated with strabismus. The presence of anomalous correspondence adds to the complexity of the case and the treatment length of the strabismus therapy. The following treatment ranges are provided as a guide and may be warranted for third-party claims processing and review purposes.

1. Full treatment requires resolution of the strabismus.
2. Anomalous retinal correspondence existing with intermittent strabismus usually requires an additional 25 hours of office therapy.
3. Anomalous correspondence may require substantially more office therapy, if complicated by associated factors such as prior eye muscle surgery, cerebral vascular accident, head trauma, and/or systemic conditions.

FOLLOW-UP CARE:

At the conclusion of the active treatment regimen, periodic follow-up evaluation is required. Should signs, symptoms, or other diagnostic factors recur, further therapy may be medically necessary. Therapeutic lenses may be prescribed during or at the conclusion of active vision therapy to assist in the maintenance of long-term stability.