Dr.Sneha Pandurangan

Dr.Shashikant Shethy

Abstract

Dissociated Vertical Deviation (DVD) is the tendency of the non-fixating eye to elevate, abduct, and extort. Despite being the least understood form of strabismus, DVD is dealt with frequently in clinics and often warrants surgical intervention. The quantification of DVD is challenging due to both inter- and intra-observer variability. A routine Prism and Alternate Cover test (PACT) does not yield a stable end point and thus cannot be relied on. It is important for a clinician to be familiar with the standard orthoptic evaluation techniques for precise measurement and surgical planning of DVD. This includes the Prism Under Cover Test, the Reversed Fixation Test, identifying the incomitance and asymmetry of DVD, quantification when presented with true vertical deviation or oblique muscle overaction, and the distinct clinical tests that qualify DVD. This video aims to demonstrate the complete orthoptic evaluation of DVD for a more reliable assessment.