Eyes with tilted disc syndrome (TDS) are likely to experience a superotemporal shifting of the line of sight, according to a new report in the November issue of Eye & Contact Lens. The Turkey-based research team analyzed 80 left eyes of 80 subjects with TDS and 70 left eyes of 70 subjects with myopia and astigmatism as controls. The team looked at the subjects’ horizontal and vertical axes, refractive, topographic and aberrometric parameters.

In the study group, they found the line of sight had significantly shifted to the superotemporal direction compared with the control group. Additionally, the shift on the y-axis was correlated with mean cylindrical refractive error, total root mean square (RMS), higher-order aberration RMS, vertical coma and vertical trefoil values. The investigators say the shift must be accounted for to prevent decentralization and provide satisfactory outcomes for refractive and multifocal intraocular lens implantation.

“This study demonstrated a superotemporal shifting of the line of sight in eyes with TDS. Preventing decentralization by correcting for line of sight coordinates is crucial for successful surgery outcomes in eyes with TDS,” the authors wrote in their paper. “The shifting of the line of sight after correction of lower-order aberrations and higher-order aberrations with custom ablation refractive surgery must be investigated further.”

TDS is a congenital anomaly caused by incomplete closure of the eye’s fetal fissure.

Kosekahya P, Sarac O, Koc M, CaglayanM, Hondur G, Cagil N. Shifting of the line of sight in tilted disk syndrome. Eye & Contact Lens 2018;44: S33–S36