Effect of prolonged dissociation on the subjective measurement of near heterophoria.

Previous studies have demonstrated that vergence adaptation resulting from the prolonged decay of slow fusional vergence may prevent the accurate assessment of oculomotor deviations. Continuing changes in heterophoria have been reported after 27 days of monocular occlusion. However, since most slow fusional vergence will decay within the first few minutes of dissociation, a clinical assessment of both vergence adaptation and heterophoria could be made more rapidly. This report documents two investigations which examined changes in near horizontal heterophoria during 30 min and 180 min of continuous dissociation, respectively. Seven out of the 16 subjects exhibited significant changes in heterophoria during the 30 min dissociation period, with a mean increase in exophoria of 3.4 delta. The decay of slow fusional vergence took approximately 25 min to reach completion. Thus in the clinical setting, both the degree of vergence adaptation and a more accurate assessment of heterophoria may be obtained by maintaining dissociation for 25 min. Furthermore, the presence of vergence adaptation can be assessed after just 5 min of dissociation.