DVD is a condition in which one eye drifts upward [See figure 1]. The eye may drift upward either frequently or infrequently. The amount of drifting may even vary during the course of the day. DVD may be present in one or both eyes. It may be more noticeable in one eye, while testing by an ophthalmologist may reveal the problem is actually present in both eyes.
DVD is not typically seen at birth and usually becomes obvious by 2-3 years of age. Occurrence is highest in those with early onset strabismus (misalignment of the eyes). It also can occur with a poorly seeing eye. DVD is highly correlated with poor fusion (decreased use of the eyes binocularly). DVD may develop years after eye muscle surgery is done for strabismus. Children with good fusion have less chance of developing DVD.
Glasses, eye patching or eye drops can sometimes reduce the frequency of the DVD. Eye muscle surgery is usually indicated when the DVD is large and/or frequently present. The goal of treatment is to minimize the frequency and the size of the DVD. In some cases, even after treatment, the DVD may still be seen.
Blurred or double vision is usually not noticed when the eye drifts upward. The visual system suppresses or blocks the vision in the eye that drifts upward.
DVD can affect vision. Since the image from the upward deviated eye is suppressed or blocked, a type of decreased visual acuity, known as amblyopia, may occur during childhood. Amblyopia is treated with glasses, eye patching, or eye drops. If amblyopia is not treated in early childhood, the decreased vision can be permanent.
Eye exercisese do not help DVD.
Last Updated 3/2012
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