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A-Pattern, V-Pattern, and Other Alphabet Pattern Strabismus

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Strabismus

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Abstract

The terms A-pattern and V-pattern describe horizontal strabismus that is vertically incomitant and has a substantial difference in the horizontal deviation between the midline upgaze and midline downgaze positions. A patient with a V-pattern is more esotropic or less exotropic in downgaze than upgaze and an A-pattern is characterized by the converse. By convention, the difference between upgaze and downgaze must be 15 prism diopters (∆) or greater to diagnose a clinically significant V-pattern and 10 ∆ to diagnose an A-pattern. Less commonly, there are variations of pattern strabismus in which there is minimal change from downgaze to the primary position, but the eyes diverge in upgaze, resulting in a Y-pattern. Converse to a Y-pattern, the main exo shift may be between the primary position and downgaze to form a “λ” (lambda) pattern. Divergence in both upgaze and downgaze constitutes an X-pattern.

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA

    Burton J. Kushner

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  1. Burton J. Kushner
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Kushner, B.J. (2017). A-Pattern, V-Pattern, and Other Alphabet Pattern Strabismus. In: Strabismus. Springer, Cham. https://doi.org/10.1007/978-3-319-63019-9_7

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  • DOI: https://doi.org/10.1007/978-3-319-63019-9_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-63018-2

  • Online ISBN: 978-3-319-63019-9

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