If the accommodation needed is more than the usual amount, such as with people with significant hyperopia, the extra convergence can cause the eyes to cross. Diagnosis
During an eye examination, a test such as cover testing or the Hirschberg test is used in the diagnosis and measurement of strabismus and its impact on vision. Retinal birefringence scanning can be used for screening of young children for eye misalignment. A Cochrane review to examine different types of diagnosis test found only one study. This study used a photoscreener which was found to have high specificity (accurate in identifying those without the condition) but low sensitivity (inaccurate in identifying those with the condition).Several classifications are made when diagnosing strabismus. Latency
Strabismus can be manifest (-tropia) or latent (-phoria). A manifest deviation, or heterotropia (which may be eso-, exo-, hyper-, hypo-, cyclotropia or a combination of these), is present while the person views a target binocularly, with no occlusion of either eye. The person is unable to align the gaze of each eye to achieve fusion. A latent deviation, or heterophoria (eso-, exo-, hyper-, hypo-, cyclophoria or a combination of these), is only present after binocular vision has been interrupted, typically by covering one eye. This type of person can typically maintain fusion despite the misalignment that occurs when the positioning system is relaxed. Intermittent strabismus is a combination of both of these types, where the person can achieve fusion, but occasionally or frequently falters to the point of a manifest deviation.
Organic personality disorder (OPD) or secondary personality change, is a condition described in the ICD-10 and ICD-11 respectively. It is characterized by a significant personality change featuring abnormal behavior due to an underlying traumatic brain injury or another pathophysiological medical condition affecting the brain. Abnormal behavior can include but is not limited to apathy, paranoia and disinhibition.In the ICD-10, it is described as a mental disorder and not included in the classification group of personality disorders. In the ICD-11, it is described as a syndrome. The condition has not been described in any edition of the Diagnostic and Statistical Manual of Mental Disorders. Signs and symptoms
OPD is associated with a large variety of symptoms, such as deficits in cognitive function, dysfunctional/abnormal behaviour, psychosis, neurosis, higher irritability and altered emotional expression. Those with OPD can experience emotional lability, meaning that their emotional expressions are unstable and fluctuating. In addition, patients may show a reduction in ability of perseverance with goals and they disinhibition, often characterised by inappropriate sexual and antisocial behavior. Those affected can experience cognitive disturbances, suspiciousness and paranoia. Altered language processing in the brain can also occur. Furthermore, patients may show changes in their sexual preference and hyposexuality symptoms. Causes
OPD is associated with "personality change due to general medical condition".