92060 Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)

Name of the Procedure:

Sensorimotor Examination with Multiple Measurements of Ocular Deviation (e.g., Restrictive or Paretic Muscle with Diplopia) - Interpretation and Report (Separate Procedure)

Summary

The sensorimotor examination involves a series of tests to measure eye movements and muscle function, particularly when there are issues like double vision (diplopia), restricted eye movements, or weakness in the eye muscles. It helps healthcare providers diagnose and determine the appropriate treatment plan for ocular motor issues.

Purpose

This procedure is used to evaluate and pinpoint the cause of issues related to eye movement and alignment. The main goals are to identify muscles that might be weak or restricted and to determine the best course of action to correct these issues, ultimately improving vision and reducing symptoms like double vision.

Indications

• Patients experiencing double vision (diplopia)
• Suspected restrictive eye muscle disorder
• Suspected paretic (weak) eye muscle
• Diagnosis and planning for eye alignment surgery
• Unexplained eye movement-related symptoms

Preparation

• No specific fasting or dietary restrictions
• Avoid wearing contact lenses on the day of the examination
• List any medications being taken
• Undergo preliminary eye exams if not recently performed

Procedure Description

1. Initial assessment: The patient’s medical history and symptoms are reviewed.
2. Visual acuity test: Basic vision test to determine clarity of vision.
3. Cover test: Used to detect misalignment by covering each eye alternately while focusing on a target.
4. Hess chart or Lancaster red-green test: A chart or test using colored filters to map the range and coordination of eye movements.
5. Prism test: Prisms are placed in front of the eye to measure the degree of deviation by observing how the eyes compensate for the prism's effect.
6. Interpretation and Report: Results are analyzed to diagnose the issue and create a detailed report with recommended treatment options.

Tools and Technology: Eye charts, prisms, colored filters, and specialized exam equipment.

Anesthesia or Sedation: Not required.

Duration

Typically, the procedure takes about 30 minutes to an hour, depending on the complexity of the patient's condition.

Setting

Usually performed in an outpatient clinic, eye specialist office, or ophthalmology department within a hospital.

Personnel

• Ophthalmologist or optometrist specializing in strabismus and eye movement disorders
• Ophthalmic technician or assistant

Risks and Complications

• Rarely, eye strain or temporary discomfort during the tests
• Accurate diagnosis essential to prevent misdiagnosis; otherwise, potential for ineffective treatment

Benefits

• Accurate diagnosis of the cause of eye movement issues
• Development of an effective treatment plan to alleviate symptoms and improve vision
• Non-invasive and relatively quick assessment

Recovery

• No significant recovery period required
• Patients can usually resume normal activities immediately after the procedure
• Follow-up appointments may be needed to discuss results and plan further treatment

Alternatives

• Magnetic resonance imaging (MRI) or computed tomography (CT) scan to investigate structural issues
• Electromyography (EMG) to study muscle activity
• Observation and symptomatic treatment without detailed diagnosis

Patient Experience

Patients may experience mild discomfort or eye strain during tests, but the procedure is generally well-tolerated. Healthcare providers will ensure the patient's comfort throughout the examination.