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PubMed1977

[Strabismus and pseudostrabismus (author's transl)].

The method of clinical examination on binocular sensory-motor connection used in the children of less than three years of age for early detection of strabismus, is used in cats. A number of common and Siamese cats were examined under the same conditions. The clinical results lead to the following conclusions: -- Contrary to general opinion, Siamese cats do not show strabismus and their binocular sensory-motor connection is well developed. -- The common cat does not show strabismus but demonstrates an exophoria or latent divergent strabismus. Their binocular sensory connections seem rather rudimentary. Though these studies have been stated categorically they are the result of clinical examination only and not of a mathematical accuracy. The veracity of these methods is confirmed by the findings in children of three years when examined by subjective methods. However, the use of experimental methods would be useful to confirm or to deny these data.

Age Factors↗

PubMed2003

Binocularity following surgical correction of strabismus in adults.

INTRODUCTION: This is a retrospective study to determine the preoperative and postoperative binocular status of adults who have undergone surgical correction of strabismus. METHODS: A list of all consecutive adult patients who underwent surgery for strabismus between June 1990 and December 2001 (surgery performed by M.B.M.) was compiled, and their medical charts were reviewed. Patients were included if their charts were available for review and if information on binocularity was recorded. Binocularity was measured by the Titmus stereo test, Worth 4-dot test, or synoptophore. Improvements or decreases in stereo acuity were noted 6 weeks postoperatively and at the final office visit. Prism management was incorporated preoperatively and/or postoperatively in some of our patients. A total of 112 patients underwent surgery for strabismus. Of these, 72 patients, aged 16 to 80, were included; 24 were excluded because their charts did not contain any information on stereo acuity at least 6 weeks postoperatively or they were lost to follow-up after surgery, and 16 were excluded because their charts were unavailable from storage. RESULTS: A variety of surgeries were performed, the most common being a bilateral medial rectus recession. Eleven patients required a second surgery, and two required a third surgery. Overall, 30 (42%) of the 72 patients improved in binocular function, 38 (53%) remained the same, and 4 (5%) had decreases in their stereo acuity. CONCLUSION: The benefits of surgical correction of strabismus in adults include improvement in binocular function, as seen in 42% of the patients in the study.

Adolescent↗

PubMed2005

[Peribulbar anaesthesia for strabismus surgery].

BACKGROUND: Strabismus surgery is underwent with general anaesthesia since it's a paediatric surgery in the majority of cases. The aim of our study is to analyse the safety and tolerance of peribulbar anaesthesia for strabismus surgery. PATIENTS AND METHODS: sixty two patients underwent strabismus surgery with a peribulbar anaesthesia. All patients had premedication the evening before and two hours bef6re the surgery. All patients were examined to evaluate the efficacy and the safety of such anaesthesia. RESULTS: The main age was 31,5 years. Forty patients were female and twenty two were male. None had report pain. Three patients report just incomfort during surgery. Orthoptic results were acceptable. CONCLUSION: Peribulbar anaesthesia has shown to be an effective alternative for general anaesthesia for strabismus surgery in an attempt to reduce the morbidity and mortality. It take importance particularly in patients of high-risk characteristics and in monocular surgery.

Adolescent↗

PubMed2005

The surgical outcome of strabismus in patients with general fibrosis syndrome.

BACKGROUND: This study investigates the clinical features of strabismus in patients with general fibrosis syndrome (GFS) and the results of surgery performed on such patients. METHODS: We conducted a retrospective review of patients with GFS who visited our clinic at Chang Gung Memorial Hospital between 1 August 1992 and 31 January 2002. After evaluating the family histories of 9 patients with GFS, patients were given a complete ophthalmic evaluation. Myectomies of the inferior rectus muscle were performed to correct hypotropia and recessions and/or resections of medial rectus and/or lateral rectus were performed to correct esotropia or exotropia, respectively. The post-operative conditions of the survey patients were reviewed for at least 6 months after the completion of the procedures. RESULTS: Six patients (67%) were identified with inherited autosomal dominance. All patients displayed the characteristic 'chin-up' position, limited extraocular muscle movement and eye abnormalities. High astigmatism (>=-2.0 diopter) was noted in 9 eyes (50%) and amblyopia was noted in all cases. With regard to vertical eye deviation, 11 eyes (61%) were corrected through myectomy of the inferior rectus muscle to within 5 degrees as measured using a Hirschberg test. Furthermore, three cases (33%) were complicated by lower scleral show. CONCLUSION: The presence of GFS complicates the surgical correction of strabismus making procedure results more difficult to predict. Strabismus surgery has been demonstrated to reduce eye deviation in the primary position, thus improving patients' head posture. The resulting improvements to cosmetic appearance and functionality lead us to recommend that strabismus surgery be performed in conjunction with ptosis surgery for GFS patients.

Female↗

PubMed2005

[Silicone union of orbital periosteum and eyeball under muscle belly for treatment of strabismus fixus].

OBJECTIVE: To evaluate the effect of silicone union of orbital periosteum and eyeball under muscle belly on the treatment of fixed paralytic strabismus. METHODS: The data from 23 cases (23 eyes) which included esotropia (22 eyes) and exotropia (1 eye) was collected, 11 and 12 patients were diagnosed as complete-fixed strabismus (CFS) and sub-fixed strabismus (SFS) respectively. After antagonist recession was completed, a silicone union (1 mm of its diameter) was used to make a connection between the anterior sclera of paralytic muscle insertion and lateral or medial canthus periosteum of orbital. Eyeball position was adjusted to orthophoria by the traction of silicone union. RESULTS: Orthophoria was obtained in all of 23 eyes. Eyes rotation compared with normal eye toward paralytic side were 25% (5 eyes), 50% (2 eyes), 75% (3 eyes) respectively after surgery. CONCLUSION: Silicone union is a elastic material, it is one of better methods for the correction of fixed strabismus.

Adolescent↗

PubMed2005

The utility of strabismus in adults.

PURPOSE: To determine the utility (quality-of-life weight) associated with adult strabismus. METHODS: Time tradeoff utility values were measured in physician-conducted interviews with 140 adult patients with strabismus in a private practice setting. Patients also completed a questionnaire containing six items that rated the following aspects of disability: specific health problems, problems with tasks of daily living, problems with social interaction, self-image problems, concerns about the future, and job-related problems. Patients were characterized as presurgical or nonsurgical, and their diplopia and asthenopia were rated by the physician on a four-level scale. RESULTS: About 60% of all patients indicated willingness to trade part of their life expectancy in return for being rid of strabismus and its associated effects. The median utility was 0.93 (interquartile range, 0.83 to 1.0). A significantly smaller proportion (44%) of the nonsurgical patients (N = 41) appeared willing to trade time compared with surgical patients (68%; P = .009). Median utility in the presurgical patients was 0.90. Strong relationships were found between utility and the level of diplopia (P < .0001), and between utility and the level of asthenopia (P < .0001). Utility was correlated with all six disability ratings (all P < or = .00062). CONCLUSION: A majority of the patients interviewed would trade a portion of their life expectancy in return for being rid of strabismus and its associated effects. These results were validated by significant associations with diplopia, asthenopia, and disability.

Activities of Daily Living↗

PubMed1990

[Variable angle strabismus and its relation to poor vision and psychomotor retardation].

Variable angle strabismus can be inward (esotropy) or outward (exotropy) or vary from esotropy to exotropy. Mental retardation has been found to be related to strabismus in 50% or more of the cases and 35% of these had variable angle strabismus. A total of 61 patients with variable angle strabismus were studied finding 55.7% with esotropy, 36% exotropy and 8.2% varying from esotropy to exotropy. Of those under study, 64% were females and 77% under five years old. No accommodative factors were found in any of the patients. The best results were obtained through surgery (recession plus Faden) previous rehabilitation.

Adolescent↗

PubMed1986

Maldevelopment of visual motion processing in humans who had strabismus with onset in infancy.

Binocular experience in infancy is necessary for the normal development of the visual cortex. However, it is not known whether binocular experience also affects the processing of specific kinds of visual information such as motion. We now report deficits in visual motion processing in 7 adult humans who lacked binocularity in infancy because of strabismus. As probes for assessing visual motion processing, we used the initiation of smooth pursuit eye movements and the judgment of target velocity independent of eye movement. Monocular viewing was essential to reveal the deficits. For horizontal pursuit, strabismic subjects showed nasal-temporal asymmetries, such that nasally directed target motion evoked more vigorous pursuit. For vertical pursuit, strabismics showed up-down asymmetries, such that upward target motion evoked more vigorous pursuit. In addition, strabismics had abnormalities in the relative effectiveness of different parts of the visual field for initiating both horizontal and vertical pursuit. Psychophysical judgements of horizontal target velocity revealed deficits analogous motion was perceived as faster than temporally directed motion, even when the 2 directions of motion were actually presented at the same speed. The magnitude of the motion processing deficits in each subject was correlated with the severity of the clinical signs of the strabismus. Our results suggest 2 possible interpretations. Maldevelopments of visual motion processing may cause strabismus in infancy, or alternatively, strabismus in the critical period for visual development may cause a maldevelopment of visual motion processing.

Adult↗

PubMed1979

Prevention and care of strabismus in infants and pre-school children.

Care of children at risk of developing strabismus is discussed. Recommended care consists of parental counseling combined with early and periodic examinations. Examinations should begin by age 3 weeks and continue at 3-6 month intervals until the child reaches age 5. Treatment of strabismus or amblyopia should begin as soon as these conditions exist. Using recent electrophysiological research as a background, a model care for infants with congenital strabismus is presented. Care reports are presented describing results of orthoptic treatment of non-congenital strabismus.

Age Factors↗

PubMed1979

[Strabismus in cerebral paretic and normal children. Comparison of motoric symptoms (author's transl)].

Investigations of 94 children with cerebral palsies have shown 55% strabismus incidence. Motoric symptoms like varying angles, nystagmus (latens), A-V phenomena, dissociated hypertropia and compulsive head postures are presented, frequently more often than in a number of comparison cases of undamaged squinting children. However, these symptoms have not permanently been found even in severly damaged children. With the exception of compulsive head postures, no symptoms are found in strabismus cases of cerebral paretic children that do not occur in congenital strabismus patients as well. A frequent family heredity strain of strabismus has also been noted. There is a striking proportion of divergence cases (27%). The authors do not believe in a simple damaging etiology. Pleoptic-orthoptic exercises are hardly ever practicable. Early operation may improve the initial situation as far as the neuropediatric therapy is concerned.

Adolescent↗

PubMed1982

Measurement of strabismus in shortened exam lanes versus the 20-foot lane.

The angle of strabismus was compared in 62 patients when measured at 10 feet and in a 20-foot mirrored system, to measurements at 20 feet. Several divergence excess type exodeviations were measured as being significantly less, relative to the 20-foot measurements. High accommodative convergence/accommodation ratio type esotropes were often measured as being significantly higher in the 10-foot room, relative to the 20-foot measurements. Having a shortened or mirrored lane for strabismus measurement could significantly alter the mode of treatment or amount of surgery in strabismus patients and possibly yield a less than optimal result in strabismus management.

Esotropia↗

PubMedDate not supplied

Strabismus: etiology, diagnosis, and treatment. American Academy of Ophthalmology.

1. Strabismus is a visual defect in which the eyes are misaligned and point in different directions. The exact cause of strabismus is not fully understood. 2. It is recommended that all children have their vision checked by their pediatrician, family doctor or ophthalmologist (medical eye doctor) at or before their fourth birthday. 3. Treatments for strabismus include surgery, eye drops, eye glasses, exercises and injections, and depend on the type of strabismus present.

Adult↗

PubMed1993

Botulinum toxin in the treatment of paralytic strabismus and essential blepharospasm.

As an alternative to conventional medical and surgical modalities that have met little success in the treatment of paralytic strabismus and essential blepharospasm, we explored the use of botulinum toxin as a treatment of choice in these two disorders. We used botulinum toxin in three patients with paralytic strabismus and in nine patients with essential blepharospasm. In three patients with paralytic strabismus, the botulinum toxin was injected into the ipsilateral antagonist of the paralysed muscle. The preinjection deviations ranged from 18 to 60 prism diopters. Two of these three patients achieved orthotropia around the thirtieth day and thereafter maintained it. The third patient became orthotropic on the eighteenth day, but deviation recurred and therefore required another injection of toxin. In nine patients with essential blepharospasm, botulinum toxin was injected into the orbicularis oculi muscles. Both objective and subjective improvement occurred in all nine patients within seven days and the effect lasted 12 to 15 weeks. Further injection of the toxin produced extremely beneficial results. However, the only significant complication that we encountered in both groups of strabismus and blepharospasm was ptosis, which was usually partial and temporary. From our experience, we advocate the use of botulinum toxin in the treatment of essential blepharospasm.

Adult↗

PubMedDate not supplied

[New concepts in the approach to congenital strabismus].

The first part of the paper reviews the clinical symptoms of congenital strabismus. Congenital strabismus passes four stages during its evolution. Spontaneous evolution becomes either alternant strabismus (stage IV a) or monolateral strabismus (stage IV b). The early treatment is to direct the evolution to the "a" form of stages III and IV and mainly consists of optical correction and occlusion.

Fixation, Ocular↗

PubMed1995

Preservation and observation of anterior ciliary vessels in rectus muscles during strabismus surgery.

PURPOSE: To observe the form and number of the anterior ciliary vessels (ACV) in rectus muscles. To train technician in preservation and observation of ACV, so preservation can be done in cases with a risk of anterior segment ischemia (ASI). METHODS: Curved foreign knife, iris hook, plastic rubber band and standard operating loupes (3x.) or microscope were used in the surgery on 34 cases of comitant strabismus and 18 cases of paralytic strabismus. RESULTS: The ACVs per muscle in medial, lateral, superior, inferior rectus were 3.08, 3.26, 3.50 and 3.50 respectively in 89 muscles of 52 surgical strabismus cases. All ACVs in 16 rectus muscles and 90 out of 220 ACVs in 73 rectus muscles were too small or too short to be dissected. The success rate of ACV preservation was 91.5% (119/130). 105 out of 130 vessels were saved using loupe magnification and 14 pit pf 130 vessels were saved under operating microscope. CONCLUSIONS: The number of ACV in rectus muscles are more than 2 in our observation cases. The ACV preservation has the clinical value of allowing us to perform muscle surgery on three or more rectus muscles simultaneously and get final surgical results more earlier after ACV in each muscle are dissected and preserved otherwise staged surgery are needed. The each strabismus surgeon must know this technique.

Adolescent↗

PubMed1996

[Refractive errors and strabismus in premature infants].

AIM: We aimed to investigate the incidence of refractive errors and strabismus in premature infants relative to their individual birth weight. METHODS: We investigated 107 premature infants with birth weight < 1250 g (group A, n = 54) and > 1250 g (group B, n = 53). All children were evaluated at the ages of 6 and 24 months for their spherical equivalent and the presence of high myopia (< or = 6.0 D) and strabismus. RESULTS: At 6 months the spherical equivalent was -0.93 +/- 4.2 D in group A and 1.09 +/- 1.9 D in group B, at 24 months -0.75 +/- 5.0 D vs 1.44 +/- 1.9 D (P < 0.01). At 6 months the incidence of high myopia was 10% in group A and 0% in group B, at 2 years 12% vs 2% (P < 0.01). Low birth weight and a long period of artificial ventilation correlated with the development of high myopia. At 6 months 21% of group A and 8.5% of group B showed strabismus, at 2 years 25% vs. 8.5% (P < 0.01). CONCLUSION: Because of the increased incidence of high myopia and strabismus we recommend routine retinoscopy and orthoptic evaluation at the age of 6 months in every child weighing less than 1250 g at birth.

Birth Weight↗

PubMed1996

[Conservative treatment of vertical recti and oblique muscle deviation in permanent and accommodative strabismus].

The aim of this study was observation of influence of exercises with hypercorrective prisms on the behavior of vertical recti and oblique muscles. The study covered 182 persons with permanent strabismus (4 persons were operated early) and 8 children with accommodative strabismus. As treatment we applied exercises with hypercorrective prisms of 35 dioptres in front of each eye with the edge in direction of the biggest deviation of the eye. A full regression of the hyperfunction of muscles was noticed in 25 patients. The favourable changes were achieved in 38 patients. However the majority of patients were not doing the exercises systematically. Surely it is not the only reason of the lack of final beneficial result of exercises. The applied localization exercises with prismatic hypercorrection in hyperfunctions of vertical recti and oblique muscles gave beneficial result in form of regression of these hyperfunctions or reduction of the range of their deviation. There was also favorable influence on the regression of "residual" deviations of eye after operations. Application of such exercises in accommodative strabismus with hyperfunction of vertical recti and oblique muscles prevent from dissociation of binocular vision and genesis of permanent strabismus.

Accommodation, Ocular↗

PubMed1996

[Strabismus in Cameroon].

PURPOSE: We undertook a study on strabismus in order to determine the characteristics of this disease in Cameroon. MATERIAL AND METHODS: A prospective study was carried out in the ophthalmological unit of the Douala General Hospital from November 1991 to October 1995. All patients were examined and followed regularly by the same team. RESULTS: We found 137 strabismus, which represent 1.22% of all patients with 51 esotropias (37.2%) and 86 exotropias (62.8%). The mean age was 13.61 years at the first consultation. 82.4% of convergent strabismus appeared before the age of one year against 67.4% of divergent strabismus. Moreover, amblyopia was found in 68.6% and 59.3% of cases respectively. CONCLUSION: As compared to European series, this study shows notably the great frequency of divergent squint in black africans and the fact that spontaneous evolution of the latter can lead to amblyopia in a large number of cases.

Adolescent↗