EFFECT OF OCULOMOTOR EXERCISES ADDED TO TEMPOROMANDIBULAR DISORDER TREATMENT: A CASE REPORT

Research Objectives: Identify the effects of oculomotor treatment added to TMD treatment in pain reducing, increasing mandibular range of motion, TMD severity and improving ocular convergence.

Design: The study was approved by the Ethics Committee of Uninove. It is a case study in which the patient participated in a pilot study for a randomized clinical trial. Patient presented with mixed TMD, experiencing pain in the masticatory muscles and convergence insufficiency.

Setting: The study was developed at the Support Center for Research in Movement Analysis (NAPAM) at the Nove de Julho University, in São Paulo.

Participants: 1 participant (case report): Patient HNE, male, 19 years old

Interventions: the patient underwent 12 physiotherapy sessions, once a week for 50 minutes, including manual techniques for TMD (intra and extraoral muscle release) and oculomotor exercises(brock lanyard, lifesaving letter and eccentric circles).

Main Outcome Measures: The main outcome measures were: Fonseca Anamnestic Index (IAF), Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), Numeric Pain Rating Scale (NPRS), and Convergence Insufficiency Symptom Survey (CISS). The patient was reassessed immediately after the 12 treatment sessions, using the same outcome measures.

Results: After completing all sessions, the patient underwent a reassessment using the same instruments, and it was observed that the pain intensity, initially rated as 7 on the NPRS, decreased to zero, indicating a clinically significant reduction of 100%. The initial diagnosis of mixed TMD in the DC/TMD assessment changed to no TMD after treatment. The pain-free maximum mouth opening increased from 42mm to 45mm after treatment, representing a clinically significant increase of 3mm. The initial IAF score of 55 (moderate severity) decreased to zero, and the CISS score decreased from 17 to 9, indicating normal binocular vision.

Conclusions: The patient no longer experiences pain, has gained mandibular range of motion, and the convergence insufficiency has been corrected. Oculomotor therapy can have a positive impact on improving the clinical condition of temporomandibular disorder.

Author(s) Disclosures: The authors Leticia Neves Mode, Fernanda Cardoso Nakamoto, Margarete Nobilo and Daniela Aparecida Biasotto-Gonzalez don"t have conflicts of interest.