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The University Ophthalmic Consultants' (UOC) comprehensive ophthalmologists can diagnose and treat most ocular disorders.
The Consultative Service's board-certified physicians perform a complete range of examinations, with appropriate diagnostic tests.
At some time during your life you may experience a sudden partial loss of vision, perceive an aura of light around objects, or flashes of light or dark shapes within your field of vision. Sometimes there is confusion when discussing ocular migraine symptoms, because the term is often used interchangeably with retinal migraine, a condition with similar symptoms that precedes or follows a migraine headache. Pay attention to triggers, such as becoming dehydrated and traveling to high altitude locations. Eye and vision conditions can lead to pain, discomfort, vision loss and may even signal life threatening systemic health problems. We employ state of the art imaging technology and work closely with referring doctors to ensure their patients are receiving the latest in treatment and management options. The Advanced Ocular Care Service provides consultations and welcomes referrals from all health care providers.
If you have trouble accessing this page and need to request an alternateformat, please contact the College of Optometry's Webmaster. The term ocular motility refers to the study of the twelve extraocular muscles and their impact on eye movement. Patients are usually tested for eye position and movement during a routine eye examination. Ocular motility photographs may be requested in order to document any improper muscle action. Strabismus is a generic term used to describe any misalignment of the eyes often due to an imbalance of the extraocular muscles. Because the brain controls eye movement through a series of cranial nerves, observing ocular movements can often give clues to help diagnose central nervous system disorders. Despite the overwhelming popularity of digital photography, motility images can be captured using either a film or digital camera.
Focusing with either system can be accomplished by moving forward and back from the subject (rocker focusing). Once the subject is in focus and properly positioned in the frame, direct the patient to look in the 9 diagnostic gazes and photograph each one. Uniform picture quality is very important, so always be aware of composition throughout the series.
Once a 9 gaze series is completed, a composite image showing all nine views is often requested. Since digital photography is by far the most popular method of image capture, any of the popular image management software, such as Adobe Photoshop, can create a nine gaze composite. With a film based camera, the easiest way to produce a composite image is to use negative film for the original photography, then re-photographing the prints.

Regardless of which option works best in your situation, once completed, your new composite image can now saved as a digital file, emailed or printed in hard copy form. When more advanced diagnosis or treatment is indicated, they will refer patients to one of UOC's outstanding subspecialists. If these symptoms come and go within a short period of time, you are probably experiencing an ocular migraine. To properly diagnose your condition, they will probably ask if the symptoms occurred in one or both eyes, exactly what symptoms were present and how long the ocular migraine symptoms lasted.
Giving your doctor a good description of the symptoms will help determine which you’ve experienced.
They are, however, a temporary disruption that can prevent you from participating in normal activities. The Advanced Ocular Care Service is the primary referral service of the Ohio State Optometry Services where patients are scheduled for diagnosis and management of their ocular conditions.
Each eye has six muscles, four rectus and two oblique, which, when functioning properly, allow the eyes to work together in a wide range of gaze. To observe the action of all twelve muscles, the patient is asked to look in the 9 diagnostic positions of gaze. These images can be used to reinforce the physician's clinical impression, for medical-legal reasons or as a starting point prior to muscle surgery. The III, IV and VI cranial nerves are used to control the extraocular muscles, thereby controlling eye movement.
Although getting the end result may differ between the two modalities, the camera techniques for capturing the images are the same.
While looking through the viewfinder, the photographer needs to sure the subject properly aligned in the frame. Having a target for the patient to fixate on will help them focus their gaze in the proper direction. While these programs will differ slightly in the step by step process, creating a digital composite is usually a a€?copy and paste' process.
After photographing the 9 diagnostic gazes, have the lab make 2" x 3" prints from the negatives. Lay the 9 print images into position, then create a pre-scan image using your scanning software. While not a dangerous condition, it can be quite disturbing, especially the first time it occurs. Given the possibility of more episodes of ocular migraine, what can be done to help reduce the number of recurrences? Work with your eye doctor to create a plan for reducing the possibility of another ocular migraine.
The patient follows a target to various points of gaze while the physician closely monitors their eye movements.

Patients with strabismus and those diagnosed with cranial nerve palsies are good candidates for motility documentation.
However, strabismus can be especially harmful to the development of vision in young children. If any of these cranial nerves are compromised, ocular motility photographs will document the affected muscles limited movement. The equipment list and method for making composites are different, but the techniques for acquiring the images remain the same. With a digital SLR, the exact magnification will be dependant on the size of the image sensor. The camera should be positioned squarely in front of the subject and the eyes should be parallel in the viewfinder. The nine gazes are: straight ahead, left, right, straight up, up and to the left, up and to the right, straight down, down and to the left, down and to the right. Some programs will allow you to create a a€?template' that can be opened every time you need to create the composite image. The prints can then be placed in their proper order into a nine sectioned, plastic file page. Any noted limitation or misalignment of the eyes could indicate muscle weakness or paralysis and warrant further investigation. For a digital camera with less than a full sensor, your lens should be set to a ratio of around 1:5. Replacing the a€?generic' focusing screen with a grid focusing screen will help keep things straight. To get an unobstructed view of the eyes in the downgaze positions, have the patient or better yet, a helper, elevate the patient's upper lids.
If you are use a digital retinal imaging system, you may be able to import your images into the program and create a 9 up.
Then simply make a photographic copy of the entire page with a digital camera and you will have created a composite image.
Referring physicians are sent expedited consult letters so necessary treatments can begin without delay. There can be a slight variance in the exact ratio, but once chosen, the ratio should remain same for all patients on that particular camera. Movement can be minimized by having the parent gently hold the child's head in the forward position. This will ensure images of the patient shot today will have the same magnification when they come back, whether it be in three months or in 3 years.

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