[Incomitance patterns in different ocular motility disorders].

Abstract

By measuring the angles stepwise through the whole field of gaze or through selected meridians the pattern of incomitance can be analyzed. It can be graphically demonstrated by "incomitance curves" or "-lines". A preliminary but very useful guess of the incomitance pattern can be obtained in performing the cover test turning the head of the patient passively in small steps. The Hess-Screen gives a quick and useful graphical overview. Synoptometer and Harms tangent screen allow a detailed study. The evaluation of the incomitance pattern allows conclusions on the etiology and explains the remaining binocular field and the head position. In neurogenic palsies, the angle increases in a linear fashion, whereas in passive motor disturbances the angle may increase sharply, change its direction in the opposite direction of gaze and show a zone of concomitance. Duanes retraction syndrome shows passive components. Examples of patients with specific incomitance patterns are shown.