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Orthoptic status before and immediately after heroin detoxification

Firth, A.Y., Pulling, S., Carr, M.P. and Beaini, A.Y. (2004) Orthoptic status before and immediately after heroin detoxification. British Journal of Ophthalmology, 88 (9). pp. 1186-1190. ISSN 1468-2079


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Aim: To determine whether changes in orthoptic status take place during withdrawal from heroin and/or methadone.

Method: A prospective study of patients, using a repeated measures design, attending a 5 day naltrexone compressed opiate detoxification programme.

Results: 83 patients were seen before detoxification (mean age 27.1 (SD 4.6) years) and 69 after detoxification. The horizontal angle of deviation became less exo/more eso at distance (p<0.001) but no significant change was found at near (p = 0.069). Stereoacuity, visual acuity, and convergence were found to be reduced in the immediate post-detoxification period. Prism fusion range, refractive error, subjective accommodation, and objective accommodation at 33 cm did not reduce but a small decrease was found in objective accommodation at 20 cm.

Conclusions: The eso trend found in these patients may be responsible for the development of acute concomitant esotropia in some patients undergoing heroin detoxification. However, the mechanism for this trend does not appear to be caused by divergence insufficiency or sixth nerve palsy.

Item Type: Article
Copyright, Publisher and Additional Information: Copyright © 2004 BMJ Publishing Group Ltd
Keywords: heroin, methadone, substance withdrawal syndrome, strabismus
Institution: The University of Sheffield
Academic Units: The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine (Sheffield) > Clinical Sciences Division South (Sheffield)
Depositing User: Repository Officer
Date Deposited: 07 Jul 2005
Last Modified: 08 Jun 2014 02:42
Published Version: http://bjo.bmjjournals.com/cgi/content/full/88/9/1...
Status: Published
Refereed: Yes
Identification Number: 10.1136/bjo.2003.032334
URI: http://eprints.whiterose.ac.uk/id/eprint/549

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