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Butterworth-Heinemann Linacre House, Jordan Hill, Oxford OX2 8DP 225 Wildwood Avenue, Woburn, MA 01801-2041 A division of Reed Educational and Professional Publishing Ltd & A member of the Reed Elsevier pic group First published 2001 Original articles © Optician 1998-1999 Revisions and new material © Reed Educational and Professional Publishing Ltd 2001 All rights reserved. No part of this publication may be reproduced in any material form (including photocopying or storing in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright holder except in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd. 90 Tottenham Court Road, London, England W1P aLP. Applications for the copyright holder's written permission to reproduce any part of this publication should be addressed to the publishers British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloguing in Publication Data A catalogue record for this book is available from the Library of Congress ISBN0750647132 Typeset by David Gregson Associates, Beccles, Suffolk Printed and bound in Spain HlIt EHRY Tn'U: TIIATWEPUBLISH, nUTIERWORTH·HEINEMANN WILL PAY FOR8TCVTOPLANT ANU CAREI'OR ATREE. Contributors Paul Adler BSe FCOptom DipCL Alec Ansons FRCS FRCOphth Angela Bishop BSe FCOptom DBO Dick Bruenech BSe PhD Sandip Doshi PhD BSe MCOptom Frank Eperjesi BSe PhD FCOptom FAAO Bruce Evans BSe PhD FCOptom DCLP FAAO Sarah Hosking PhD MCOptom FAAO DBO Adrian Jennings PhD FCOptom John Siderov PhD MSeOptom MCOptom FAAO Alison Spencer DBO Preface This book started life as a compilation of a series of 16 articles that were published in the journal Optician between 1998 and 2000. Nine leading experts in the field of binocular vision and orthoptics were invited to write these articles. The series was acclaimed a success. and led to the idea for this venture. Each author was invited to update their article to form the chapters of this book. It is due to the willingness and enthusiasm of these individuals that this book has been possible. and we thank them for this. The original articles were designed to meet the needs of eye-care professionals who encounter binocular vision anomalies; hence the reader will find that this book is biased towards the commonest clinical binocular vision problems. Several chapters concentrate on the very common conditions of heterophoria and vergence anomalies. particularly convergence insufficiency. Different authors have been invited to cover these important topics from slightly different approaches. and it is our belief that this diversity of expert opinion strengthens the book. Indeed, whilst this book is cohesive in its content, it is hoped that the presentation of different authors' approaches will help readers to gain a balanced perspective. More than 90 per cent of NHS contacts are said to occur in primary care. With its focus aimed at practitioners working in this sector, Binocular Vision and Orthoptics has been designed to stress investigations and treatments that are appropriate in this area of patient care. Although a great many orthoptic problems can be treated in this environment, some can only be treated medically or surgically, and these topics are also covered in this book. Some of the topics in Binocular Vision and Orthoptics are dealt with in more detail in another Butterworth-Heinemann book. Pickwell's Binocular Vision Anomalies, written by Dr Bruce Evans. For the keen reader this bo