I am optometrist Ispahani Islamia eye Institute and hospital Farmgate Dhaka in Bangladesh

1. OTT then and now
Synoptophore
Md.Anamul haq
Asso.optometrist
Ispahani Islamia eye Institute and hospital.
B.Optom(Dbu)India
Mch(Ds&Hospital)
Orthoptist.(iiei&h

2. What is synoptophore
It is a useful orthoptics tool
specifically for the diagnosing the
subjective and objective angles of
squint .this is the instrument that
performs a comprehensive.
assessment of binocular vision by
training the ocular muscles .allowing
the visual stimuli to the projected on
each eye separately.

3. Cont….
• An instrument for diagnosing imbalance of eye muscles and
treating them by orthoptic methods.
• An instrument used in orthoptic to present to the subject
images at different angles of convergence or divergence so
that the fusional ability can be tested.
Syn Opto phore
Both Eye Range

7. Principle
• Haploscopic principle
• Syn are designed on the principle of division of ``physical
space`` into two separate areas of ``visual space`` each of
which is visible to one eye only.
• The object and its image are ``conjugate``being join by the
optical system so that if test object pictures are placed in a
choosen position relative to each other it follows that the
image will be directed into similar relative positions.
• By altering the position of the test objects in an instrument
that their image can be made to stimulate selection retinal
areas as requires.

8. Anatomy of Synoptophore

9. SLIDES USED IN SYNOPTOPHORE

10. SLIDES
Simultaneous perception slides
i. These are two dissimilar slides of two different picture
which can be overlapped.
ii. Each slide is presented separately to each eye.
iii. Each slide size has been calculated to subtend a
different angle at the nodal point of the eye.
iv. These are graded into 3 groups by their size
1) foveal.
2) macular.
3) paramacular.

11. Cont……
1) Foveal –
• These slides have small sized pictures
• They do not exceed the size of the fovea
• Foveal slide-1`
2) Macular –
• They have pictures slightly larger than the foveal slides
• Macular slide 1-3`
3) Paramacular –
• They have the largest pictures that extends into
paramacular areas
• Paramacular slide 1-5`

14. Fusion Slides
• Consists of two similar pictures each of which is
incomplete in each details. For ex-two rabbits each
laching a tail or a bunch of flowers.
• If there is presence of fusion in a patient then he will see
the complete image of the rabbit holding a bunch of
flowers and tail.
• In the presence of suppression either tail or bunch of
flowers be missing.

17. STEROPSIS SLIDES
• Consisting of two pairs of same objects hypothetically taken
from slightly different angles to indicate depth perception.
• These slides are inserted into the slide holders with the
controls of each slide positioned towards or away from the
subject.
• The patient is then required to describe the apparent effect.

22. Diagnosis
Asssessment of binocular status.
-smp
-fusion
-stereopsis
. for foveal ,macular and paramacular retinal areas.
 Measurement of range of fusion.
 Case with incomplete suppression can also be tested by using
differential illumination and by using flashing device appreciation
of entoptic haidinger,brushes.
 Measurement of inter pupillary distance .
 Measurement of angle kappa.
 Measurement of deviation in all cardinal direction of gaze.
 Measurement of ACA ratio.
 “After image’’ testing.
 Measurement of deviation.

23. Therapeutic
• Fusional vergence exercise.
• Management of suppression antisuppression exercise.
• Treatment of ARC.
• Amblyopia therapy with help of haidinger brushes.
• Eccentric fixation.
• Accomodative esotropia.
• Heterophorias and intermittent heterophorias.

25. ADVANTAGES
• Accurate measurement is possible.
• Tube can move separately.
• Large selection of suitable slides are available.
• The patients eye can be seen by the examiner and the
corneal reflections can be observed.
• There can be rapid interchange from objective to
subjective conditions.

26. Disadvantages
 Not useful in non cooperative child.
 Bulky instrument ,difficult to transfer from one place to
other.
 Though the slides are kept in optical infinity distance
but still it stimulates proximal accommodation of the
patient.
 Needs skill to handle the instrument accurately.

27. Advice &
questions

28. Happy Ramadan in
advance