Sühan Tomaç | Aksaray University (original) (raw)

Videos by Sühan Tomaç

This patient had negative cover test. Her visual acuity 20/200 on the RE and there was no refrac... more This patient had negative cover test. Her visual acuity 20/200 on the RE and there was no refractive error. The cause of her poor visual acuity had been researched a lot in the past and the it had not been found, whereas Irvine prism test and visuoscopy was sufficient for diagnosis. On visuoscopy, nasal parafoveolar fixation was found. Another important point on the video is that the pathological response on the RE does not change to normal by using prisms of different directions and powers, which is objectively demonstrates that the absence of suppression scotoma

1 views

Papers by Sühan Tomaç

Journal of pediatric ophthalmology and strabismus

To investigate whether restoration of normal stereo acuity is possible in refractive accommodativ... more To investigate whether restoration of normal stereo acuity is possible in refractive accommodative esotropia. Twenty patients with refractive accommodative esotropia were included in the study. The cycloplegic refraction and the best corrected visual acuity of each patient were recorded. The patients were evaluated by the 4-prism-diopter test, Bagolini striated glasses, the Worth 4-dot test, the TNO stereo test, and the stereo fly plate of the Titmus test. Eight patients had orthotropia with normal retinal correspondence and 12 patients had a small deviation with abnormal retinal correspondence. Nine patients (8 patients with orthotropia and 1 patient with microtropia) demonstrated a gross level of stereo acuity, whereas the others demonstrated no stereopsis. In patients with refractive accommodative esotropia, the prognosis is not favorable for restoration of normal stereopsis, even if orthotropia is achieved.

Turkiye Klinikleri Journal of Ophthalmology, 2007

Investigative Ophthalmology & Visual Science, 2005

Turkiye Klinikleri Journal of Surgical Medical Sciences, 2006

Neuro-Ophthalmology, 2021

Journal of pediatric ophthalmology and strabismus

To investigate whether restoration of normal stereo acuity is possible in refractive accommodativ... more To investigate whether restoration of normal stereo acuity is possible in refractive accommodative esotropia. Twenty patients with refractive accommodative esotropia were included in the study. The cycloplegic refraction and the best corrected visual acuity of each patient were recorded. The patients were evaluated by the 4-prism-diopter test, Bagolini striated glasses, the Worth 4-dot test, the TNO stereo test, and the stereo fly plate of the Titmus test. Eight patients had orthotropia with normal retinal correspondence and 12 patients had a small deviation with abnormal retinal correspondence. Nine patients (8 patients with orthotropia and 1 patient with microtropia) demonstrated a gross level of stereo acuity, whereas the others demonstrated no stereopsis. In patients with refractive accommodative esotropia, the prognosis is not favorable for restoration of normal stereopsis, even if orthotropia is achieved.

Ophthalmic and Physiological Optics, 2007

To investigate binocularity in Duane's retraction syndrome (DRS) and to evaluate whether or not t... more To investigate binocularity in Duane's retraction syndrome (DRS) and to evaluate whether or not there is a relationship between the sensory and clinical features of the syndrome. Clinical and sensory findings of 29 patients with DRS were recorded. Binocularity was tested with the Bagolini glasses (BG), Worth four-dot (W4D), TNO and the stereo-fly plate of the Titmus test. Twenty-four (83%) patients showed fusion with the BG at near and 23 (79%) had fusion at distance. With the W4D, 23 (79%) patients had fusion at near and 19 (65%) had fusion at distance. Seven (24%) patients demonstrated normal stereoacuity, 15 (52%) had reduced stereoacuity and the remaining seven (24%) patients had no measurable stereoacuity. In patients without stereoacuity, amblyopia (p < 0.001), type 2 and 3 DRS (p = 0.031) and exotropia (p = 0.003) in primary position were more common than in those with reduced or with normal stereoacuity. Restriction of ocular ductions was also more severe in patients without stereoacuity than in those with reduced or normal stereoacuity (p = 0.019, p = 0.016). Patients with type 2 and 3 DRS were significantly more likely to have amblyopia (p = 0.037), large-angle heterotropia (p = 0.005) in primary position, upshoot or downshoot (p = 0.010) than those with type 1 DRS. Although approximately 75% of DRS patients had fusion and measurable stereoacuity, only 25% demonstrated normal binocularity. This report provides new data on the relationship of sensory features to most of the clinical findings of this syndrome. Sensory features, as well as most clinical features of the syndrome, are better in patients with type 1 DRS.

Journal of Neuro-Ophthalmology, 2005

International Ophthalmology, 2006

To investigate whether the positive prism test response is due to the presence of a suppression s... more To investigate whether the positive prism test response is due to the presence of a suppression scotoma or the absence of bifoveolar fixation. Fifty-one subjects with esotropia (microtropia, small-, moderate- or large-angle esotropia), and 22 subjects with nonstrabismic anisometropic amblyopia were examined. The prism test was performed by using base-out prisms of two different powers (4-PD and 30-PD), and base-in prism of 20-PD, as well as base-down prism of 10-PD for each subject. All the subjects with esotropia showed a positive prism test response, whereas all the subjects with nonstrabismic anisometropic amblyopia had a negative prism test response. All the esotropic subjects showed positive response to all magnitudes and positions of the prisms tested. The positive response to the prism test does not indicate suppression scotoma in subjects with microtropia and small-angle esotropia because all the esotropic subjects showed the positive response regardless of the amount of deviation or the sensorial adaptation mechanisms. Also, the positive response, seen in the esotropic subjects, did not alter to negative by using the prisms of different powers and directions.

Binocular vision & strabismus quarterly

To report a case in which strabismus surgery did not eliminate the abnormal head posture although... more To report a case in which strabismus surgery did not eliminate the abnormal head posture although it did improve the vertical strabismus; and to consider the causes of this situation. The patient had a right eso-hypertropia and ocular torticollis to the left shoulder as a result of a right superior oblique mechanical deficiency, secondary to her craniosynostosis. A myectomy of the right inferior oblique muscle and a tucking procedure of the right superior oblique muscle were performed. Postoperatively, the abnormal head posture persisted, although strabismus surgery improved the vertical deviation. However, improvement of the abnormal head posture upon patching the deviated eye only indicated that the origin of the persistent abnormal head posture must be ocular. Further tests revealed that an anomalous retinal correspondence (ARC) with eccentric fixation was responsible. In patients with ocular torticollis, ARC with eccentric fixation must be ruled out prior to surgery as these may negatively affect the outcome.

Binocular vision & strabismus quarterly

Because of controversial results in previous reports, we wished to further evaluate stereoacuity ... more Because of controversial results in previous reports, we wished to further evaluate stereoacuity development in children with normal binocular vision, and to investigate the reliability of stereoscopic tests for screening for abnormal binocular vision and amblyopia. In a prospective study, 115 children, age 3 to 6 1/2 years, were first tested on the TNO and Titmus Stereotests, after which they received a more complete eye examination to determine the presence of ocular and vision abnormalities. Only specific quantitative stereotest results were tabulated for the development study. Binocular vision anomalies were detected by stereotesting in 3 of the 115 children. Testability was better on the TNO than the Titmus Stereotest. Using only the quantitative stereotest results, when segregated by age groups, there was a "statistically significant" change (improvement with age) on the TNO Test (p=.0001)(x2); whereas there was no such improvement found on the Titmus Stereotest Circ...

Journal of Pediatric Ophthalmology & Strabismus

To investigate the effects of anisometropia on binocular function and the relationship between st... more To investigate the effects of anisometropia on binocular function and the relationship between stereopsis and fusion in anisometropia. Twenty-five patients with anisometropia were studied. The manifest refraction and best-corrected Snellen visual acuity of each patient was recorded. Patients, corrected with spectacles, were evaluated using Bagolini glasses, the 4-diopter (D) prism test, Worth four-dot test, and TNO stereotest. All patients indicated fusion by the Bagolini glasses. Although the 4-D prism test was positive in the anisometropic eye of all 25 patients, it was slower than the response of the other eye in 19 patients with reduced stereoacuity. On the distant Worth four-dot test, fusion response was positive in 15 patients. On theTNO test, stereoacuity levels were reduced or absent in 19 patients. The depth of amblyopia is more effective than the amount of anisometropia in causing a deterioration in binocularity. Even if fusion is weak, almost all patients with anisometrop...

Binocular vision & strabismus quarterly, 1999

A 22 year old female presented with sudden onset of uncrossed diplopia at distance, intracranial ... more A 22 year old female presented with sudden onset of uncrossed diplopia at distance, intracranial hypertension, esotropia and was evaluated. Microbiological tests of CSF and sera showed for brucellosis and the patient received therapy for this and her intracranial hypertension. The papilledema, headache, esotropia and diplopia all disappeared after therapy. Diagnostic tests for brucella must be considered for patients who have divergence palsy and papilledema, especially those living in endemic areas.

Strabismus, 2000

The aim of this study was to investigate the hemodynamic changes that may occur in the retrobulba... more The aim of this study was to investigate the hemodynamic changes that may occur in the retrobulbar circulation after strabismus surgery, using color Doppler ultrasonography (CDI). Fifteen healthy volunteers (control group, n=15) and sixteen patients diagnosed with strabismus were enrolled in the study. Either recession or resection was planned on one horizontal rectus muscle in the eyes of Group 1 (n=11) and on two horizontal rectus muscles in the eyes of Group 2 (n=10). CDI was performed to measure peak systolic velocity (V(max)), end-diastolic velocity (V(min)) and mean blood flow velocity (V(mean)) in the ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) in the control group and in Groups 1 and 2, both preoperatively and 2-7 days postoperatively. The postoperative resistivity indexes in Groups 1 and 2 were found to be different from those in the control group. Preoperative V(max) and postoperative V(min) and V(mean) values of the vessels in Group 2 were different from those in both Group 1 and the control group (p<0. 001). In both treatment groups, the differences between postoperative and preoperative measurements of the parameters in the OA, CRA and PCA demonstrated statistical significance (p<0.001). After strabismus surgery on the horizontal recti, there are some alterations in the retrobulbar blood flow with a significant difference between pre- and postoperative blood flow velocities after single and double rectus surgery. The clinical significance of these results needs to be determined because CDI may be a useful tool in the investigation of hemodynamic alterations after anterior segment interventions that may cause anterior segment ischemia.

This patient had negative cover test. Her visual acuity 20/200 on the RE and there was no refrac... more This patient had negative cover test. Her visual acuity 20/200 on the RE and there was no refractive error. The cause of her poor visual acuity had been researched a lot in the past and the it had not been found, whereas Irvine prism test and visuoscopy was sufficient for diagnosis. On visuoscopy, nasal parafoveolar fixation was found. Another important point on the video is that the pathological response on the RE does not change to normal by using prisms of different directions and powers, which is objectively demonstrates that the absence of suppression scotoma

1 views

Journal of pediatric ophthalmology and strabismus

To investigate whether restoration of normal stereo acuity is possible in refractive accommodativ... more To investigate whether restoration of normal stereo acuity is possible in refractive accommodative esotropia. Twenty patients with refractive accommodative esotropia were included in the study. The cycloplegic refraction and the best corrected visual acuity of each patient were recorded. The patients were evaluated by the 4-prism-diopter test, Bagolini striated glasses, the Worth 4-dot test, the TNO stereo test, and the stereo fly plate of the Titmus test. Eight patients had orthotropia with normal retinal correspondence and 12 patients had a small deviation with abnormal retinal correspondence. Nine patients (8 patients with orthotropia and 1 patient with microtropia) demonstrated a gross level of stereo acuity, whereas the others demonstrated no stereopsis. In patients with refractive accommodative esotropia, the prognosis is not favorable for restoration of normal stereopsis, even if orthotropia is achieved.

Turkiye Klinikleri Journal of Ophthalmology, 2007

Investigative Ophthalmology & Visual Science, 2005

Turkiye Klinikleri Journal of Surgical Medical Sciences, 2006

Neuro-Ophthalmology, 2021

Journal of pediatric ophthalmology and strabismus

To investigate whether restoration of normal stereo acuity is possible in refractive accommodativ... more To investigate whether restoration of normal stereo acuity is possible in refractive accommodative esotropia. Twenty patients with refractive accommodative esotropia were included in the study. The cycloplegic refraction and the best corrected visual acuity of each patient were recorded. The patients were evaluated by the 4-prism-diopter test, Bagolini striated glasses, the Worth 4-dot test, the TNO stereo test, and the stereo fly plate of the Titmus test. Eight patients had orthotropia with normal retinal correspondence and 12 patients had a small deviation with abnormal retinal correspondence. Nine patients (8 patients with orthotropia and 1 patient with microtropia) demonstrated a gross level of stereo acuity, whereas the others demonstrated no stereopsis. In patients with refractive accommodative esotropia, the prognosis is not favorable for restoration of normal stereopsis, even if orthotropia is achieved.

Ophthalmic and Physiological Optics, 2007

To investigate binocularity in Duane's retraction syndrome (DRS) and to evaluate whether or not t... more To investigate binocularity in Duane's retraction syndrome (DRS) and to evaluate whether or not there is a relationship between the sensory and clinical features of the syndrome. Clinical and sensory findings of 29 patients with DRS were recorded. Binocularity was tested with the Bagolini glasses (BG), Worth four-dot (W4D), TNO and the stereo-fly plate of the Titmus test. Twenty-four (83%) patients showed fusion with the BG at near and 23 (79%) had fusion at distance. With the W4D, 23 (79%) patients had fusion at near and 19 (65%) had fusion at distance. Seven (24%) patients demonstrated normal stereoacuity, 15 (52%) had reduced stereoacuity and the remaining seven (24%) patients had no measurable stereoacuity. In patients without stereoacuity, amblyopia (p < 0.001), type 2 and 3 DRS (p = 0.031) and exotropia (p = 0.003) in primary position were more common than in those with reduced or with normal stereoacuity. Restriction of ocular ductions was also more severe in patients without stereoacuity than in those with reduced or normal stereoacuity (p = 0.019, p = 0.016). Patients with type 2 and 3 DRS were significantly more likely to have amblyopia (p = 0.037), large-angle heterotropia (p = 0.005) in primary position, upshoot or downshoot (p = 0.010) than those with type 1 DRS. Although approximately 75% of DRS patients had fusion and measurable stereoacuity, only 25% demonstrated normal binocularity. This report provides new data on the relationship of sensory features to most of the clinical findings of this syndrome. Sensory features, as well as most clinical features of the syndrome, are better in patients with type 1 DRS.

Journal of Neuro-Ophthalmology, 2005

International Ophthalmology, 2006

To investigate whether the positive prism test response is due to the presence of a suppression s... more To investigate whether the positive prism test response is due to the presence of a suppression scotoma or the absence of bifoveolar fixation. Fifty-one subjects with esotropia (microtropia, small-, moderate- or large-angle esotropia), and 22 subjects with nonstrabismic anisometropic amblyopia were examined. The prism test was performed by using base-out prisms of two different powers (4-PD and 30-PD), and base-in prism of 20-PD, as well as base-down prism of 10-PD for each subject. All the subjects with esotropia showed a positive prism test response, whereas all the subjects with nonstrabismic anisometropic amblyopia had a negative prism test response. All the esotropic subjects showed positive response to all magnitudes and positions of the prisms tested. The positive response to the prism test does not indicate suppression scotoma in subjects with microtropia and small-angle esotropia because all the esotropic subjects showed the positive response regardless of the amount of deviation or the sensorial adaptation mechanisms. Also, the positive response, seen in the esotropic subjects, did not alter to negative by using the prisms of different powers and directions.

Binocular vision & strabismus quarterly

To report a case in which strabismus surgery did not eliminate the abnormal head posture although... more To report a case in which strabismus surgery did not eliminate the abnormal head posture although it did improve the vertical strabismus; and to consider the causes of this situation. The patient had a right eso-hypertropia and ocular torticollis to the left shoulder as a result of a right superior oblique mechanical deficiency, secondary to her craniosynostosis. A myectomy of the right inferior oblique muscle and a tucking procedure of the right superior oblique muscle were performed. Postoperatively, the abnormal head posture persisted, although strabismus surgery improved the vertical deviation. However, improvement of the abnormal head posture upon patching the deviated eye only indicated that the origin of the persistent abnormal head posture must be ocular. Further tests revealed that an anomalous retinal correspondence (ARC) with eccentric fixation was responsible. In patients with ocular torticollis, ARC with eccentric fixation must be ruled out prior to surgery as these may negatively affect the outcome.

Binocular vision & strabismus quarterly

Because of controversial results in previous reports, we wished to further evaluate stereoacuity ... more Because of controversial results in previous reports, we wished to further evaluate stereoacuity development in children with normal binocular vision, and to investigate the reliability of stereoscopic tests for screening for abnormal binocular vision and amblyopia. In a prospective study, 115 children, age 3 to 6 1/2 years, were first tested on the TNO and Titmus Stereotests, after which they received a more complete eye examination to determine the presence of ocular and vision abnormalities. Only specific quantitative stereotest results were tabulated for the development study. Binocular vision anomalies were detected by stereotesting in 3 of the 115 children. Testability was better on the TNO than the Titmus Stereotest. Using only the quantitative stereotest results, when segregated by age groups, there was a "statistically significant" change (improvement with age) on the TNO Test (p=.0001)(x2); whereas there was no such improvement found on the Titmus Stereotest Circ...

Journal of Pediatric Ophthalmology & Strabismus

To investigate the effects of anisometropia on binocular function and the relationship between st... more To investigate the effects of anisometropia on binocular function and the relationship between stereopsis and fusion in anisometropia. Twenty-five patients with anisometropia were studied. The manifest refraction and best-corrected Snellen visual acuity of each patient was recorded. Patients, corrected with spectacles, were evaluated using Bagolini glasses, the 4-diopter (D) prism test, Worth four-dot test, and TNO stereotest. All patients indicated fusion by the Bagolini glasses. Although the 4-D prism test was positive in the anisometropic eye of all 25 patients, it was slower than the response of the other eye in 19 patients with reduced stereoacuity. On the distant Worth four-dot test, fusion response was positive in 15 patients. On theTNO test, stereoacuity levels were reduced or absent in 19 patients. The depth of amblyopia is more effective than the amount of anisometropia in causing a deterioration in binocularity. Even if fusion is weak, almost all patients with anisometrop...

Binocular vision & strabismus quarterly, 1999

A 22 year old female presented with sudden onset of uncrossed diplopia at distance, intracranial ... more A 22 year old female presented with sudden onset of uncrossed diplopia at distance, intracranial hypertension, esotropia and was evaluated. Microbiological tests of CSF and sera showed for brucellosis and the patient received therapy for this and her intracranial hypertension. The papilledema, headache, esotropia and diplopia all disappeared after therapy. Diagnostic tests for brucella must be considered for patients who have divergence palsy and papilledema, especially those living in endemic areas.

Strabismus, 2000

The aim of this study was to investigate the hemodynamic changes that may occur in the retrobulba... more The aim of this study was to investigate the hemodynamic changes that may occur in the retrobulbar circulation after strabismus surgery, using color Doppler ultrasonography (CDI). Fifteen healthy volunteers (control group, n=15) and sixteen patients diagnosed with strabismus were enrolled in the study. Either recession or resection was planned on one horizontal rectus muscle in the eyes of Group 1 (n=11) and on two horizontal rectus muscles in the eyes of Group 2 (n=10). CDI was performed to measure peak systolic velocity (V(max)), end-diastolic velocity (V(min)) and mean blood flow velocity (V(mean)) in the ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) in the control group and in Groups 1 and 2, both preoperatively and 2-7 days postoperatively. The postoperative resistivity indexes in Groups 1 and 2 were found to be different from those in the control group. Preoperative V(max) and postoperative V(min) and V(mean) values of the vessels in Group 2 were different from those in both Group 1 and the control group (p<0. 001). In both treatment groups, the differences between postoperative and preoperative measurements of the parameters in the OA, CRA and PCA demonstrated statistical significance (p<0.001). After strabismus surgery on the horizontal recti, there are some alterations in the retrobulbar blood flow with a significant difference between pre- and postoperative blood flow velocities after single and double rectus surgery. The clinical significance of these results needs to be determined because CDI may be a useful tool in the investigation of hemodynamic alterations after anterior segment interventions that may cause anterior segment ischemia.