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EW NEWS & OPINION 24 October 2014 "Our main message is we need to look at these disorders because they are often quite treatable," Dr. Leat said. When investigators looked at the factors that were associated with having a binocular vision disorder, several came to light. "For certain groups we found that antidepres- sants was one of the factors that was most associated with having a binocular vision disorder," Dr. Leat said. Investigators considered antidepressants because of sugges- tions in the literature that use of such medications might be associ- ated with diplopia, she explained. However, those studies did not consider the prevalence of binocular vision and eye movement disorders in conjunction with antidepressant use. by Maxine Lipner EyeWorld Senior Contributing Writer New view on the eye team With this in mind, investiga- tors made their definition stricter in terms of what fell under the umbrella of binocular vision and eye movement disorders. With this stricter definition, D . Leat noted that prevalence did go down to a range from 27% to 38%, still being higher with older age. "That's still pretty high though," she said. Findings The most important finding was that binocular vision and eye move- ment disorders are common in older people, she said, and these are often overlooked. Many practitioners are concerned about eye disease, such as glaucoma and age-related macular degeneration, and may not spend much time thinking about binocular vision disorders. are related to binocular vision and eye movement and for each of those tests looked at what would be expected to be normal," she said. "Then we counted up the number of people who had a result that was outside the normal range and counted up the prevalence of having any abnormal test result of binocu- lar vision tests and eye movement tests." Using this criteria, investi- gators found that 51% of people in the oldest group, 44% of those in the middle, and 41% of those in the youngest group had some kind of binocular vision or eye movement disorder. "That's a very high frequency for any clinical finding," D . Leat said. "But then we realized that hav- ing an abnormal test result doesn't necessarily mean that the person is having a functional difficult ." Considering links to binocular vision disorders A s we age, the eye's ability to function and move together binocularly decreases, according to Susan J. Leat, PhD, FCOptom, professor of optometry and vision science, University of Waterloo, Ontario, Canada. In a first-of-its-kind study quantifying binocular vision loss in older adults, there was a correlation between abnormal binocular vision, gener- al health and antidepressant use, as well as other factors, Dr. Leat reported. The work grew out of Dr. Leat's examination of the reason for falls in older adults. "Falls in older people is a big topic right now because they cause a lot of hardship, resulting in poor health, increased mortality and healthcare costs," Dr. Leat said. If a patient has poor binocular vision, he or she most likely has poor depth perception, making him/ her more prone to falls, she said. Dr. Leat, who also teaches a geriatric optometry course, realized that there is a lot of data available involving this population that has not yet been analyzed. "We were curious to find out what would be the prevalence of binocular vision disorders in older adults for those reasons," she said. Considering prevalence The retrospective study included data taken from the files of 500 p - tients at the University of Waterloo Optometry Clinic over a 1-year pe- riod. "We selected patients who had been here for at least 10 years," she said. "We took the most recent full eye exam data, and we went back 10 years and took a full eye exam from then." Patients were stratified into 1 of 3 age groups, she said, adding that this included an equal number of people between the ages of 60 and 69, 70 and 79, and 80 plus. Investi- gators had access to exam findings from these same patients 10 years earlier. As part of the study, investi- gators looked for an abnormal test finding. " e looked at all of the tests that we do in the clinic that When investigators looked for abnormal test findings in patient ecords, they determined that older adults were most likely to have eye movement disorders. Source: National Eye Institute continued on page 26