Vision defects in dysfunctional and orthodontic patients: clinical evaluation

Aim: In literature little interest has been shown in the relationship between temporomandibular disorders (TMD) and vision defects, although both diseases are very widespread in the Italian population. According to recent studies, temporomandibular disorders, orthodontic diseases and vision defects are strictly related. There are no studies on large sample that can establish the report with scientific certainty. The correlation between each individual temporomandibular disorder based on a possible diagnostic classification of TMDs and each individual vision defect is not specified. The low quality of the works, their heterogeneity, the difficulty of making valid comparisons, requires great caution in considering these connections scientifically sustainable, both in diagnostic phase and in therapeutic phase. Therefore, the purpose of this study is to prove and describe the relationship; to evaluate the incidence, prevalence and distribution of vision defects in dysfunctional and orthodontic patients. Methods: 334 patients were selected from the Unit of Gnathology and the COU of Orthodontics of Policlinico Umberto I of Sapienza University of Rome. A prospective experimental observational cohort study has been conducted. All of them were analyzed through a complete gnathological and/or orthodontic specialist examination by the same calibrated personnel. TMDs were classified with the international diagnostic criteria (DC/TMD). According to specific gnathological, orthodontic and orthoptic inclusion and exclusion criteria, 100 patients were recruited. At the COU of Ophthalmology of the same hospital they were analysed by performing specific evaluation tests (visus exam, cover test, corneal reflex, ocular motility, convergence test). A descriptive and statistical analysis of the data was carried out with the SPSS software by IBM system. Results : The comparison with the Italian population has revealed a higher frequency of refractive defects in the study sample: myopia is increased from 26.5% to 38%; astigmatism in increased from 16.7% to 40%; hypermetropia is increased from 6.9% to 22% (P <. 001). Significant is the increased frequency of ocular convergence reduction in the presence of reducible disk dislocation (RDD) (n = 28; 60%; P <.05). Patients with asymmetry, show high frequencies of motor ocular deviations (n = 59; 100%) (P <. 05). Conclusion: From the data of this preliminary research, a positive correlation seems to emerge between some of the variables analyzed. As results, the single most interesting associations have been resulted between functional disease (RDD) and skeletal alteration (asymmetry) with oculomotor alterations like convergence reduction and motor ocular deviations. Despite the significant association between the two anomalies, no gnathological or orthodontic treatment is justified when vision defects are present. It is, however, appropriate to evaluate the presence of vision defects in dysfunctional and orthodontic patients.