Recovery of phorias following monocular occlusion

Fourteen nonstrabismic volunteers were monocularly patched for 2 and 24 hours in separate experiments. Horizontal and vertical phorias were measured at 6 m and 30 cm, at 30-second intervals, for at least 30 minutes, following removal of the patch. After 24 hours of monocular occlusion, the initial change from baseline at 6 m ranged from 9.5 prism diopters exo to 7 Δ eso and 6.5 Δ hyper to 3 Δ hypo. At 30 cm, the initial change ranged from 7.5 Δ exo to 4 Δ eso and 1 Δ hyper to 1 Δ hypo. In all but three subjects, phorias returned to within 2 Δ of baseline by 3 minutes, and in all subjects by 25 minutes. After 2 hours of monocular occlusion, the range of initial change from baseline was similar to 24 hours of occlusion, but all phorias returned to within 2 Δ of baseline by 2.5 minutes. Therefore, we suggest that ocular alignment should not be routinely measured within 3 minutes of removing a patch. If patched for 24 hours, a few individuals will require up to 25 minutes for stabilization of their deviation. Further studies might address these effects in patients with subnormal fusion and stereopsis.