SEARCH · PubMed Health

Results for “Strabismus”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources

PubMed1992

[Strabismus induced by peripheral vestibular lesions].

Little attention has been paid in the ophthalmological literature to strabismus resulting from lesions located in the peripheral vestibular system. However, this phenomenon is commonly encountered in clinical practice. As a rule, this kind of strabismus shows a prominent vertical component. It is generally combined with a change in perception of verticality, conjugate cyclotorsion of the eyes, and head tilt. This association is known as "ocular tilt reaction". It occurs in a number of clinical settings which are believed to be related with alteration in the otolithical and/or vertical semicircular canal pathways. Strabismus occurring as a feature of ocular tilt reaction might result from different mechanisms according to the location of the lesion, e.g. in the utricles, in the midbrain tegmentum, and in the dorso-lateral medulla oblongata. This phenomenon is illustrated here with the report of a patient suffering from Ménière disease, who underwent selective vestibular neurectomy. Methods of ophthalmological evaluation in such cases is described.

Aged↗

PubMed2001

Age of the emergence of negative attitudes toward strabismus.

INTRODUCTION: Strabismus impacts a variety of psychosocial variables in both children and adults. Poor self-esteem, lack of confidence, altered interpersonal relationships, and difficulty with employment procurement have been reported. The purpose of this study was to determine the age at which children perceive strabismus in dolls and to evaluate their reactions. METHODS: Three identical dolls were altered so that one was orthotropic, one esotropic, and one exotropic. Thirty-four naïve children between 3 and 7 years of age were individually placed in a waiting room with the 3 dolls as the only toys with which to play. A one-way mirror allowed a hidden observer to tabulate the number of positive and negative behaviors exhibited toward each doll. After a 10-minute observation period, the children were asked a short series of questions about their preferences and attitudes toward the dolls. Odds ratios were then determined for both the observed behaviors and the expressed responses to the strabismic dolls compared with the orthotropic dolls. RESULTS: Children aged 5(3/4) years and older were 73 times more likely than younger children to express a negative feeling about the strabismic dolls when asked (P =.003). Additionally, when comparing the strabismic dolls with the orthotropic doll, children aged 3 to 4(1/4) years did not notice a difference, children aged 4(1/2) to 5(1/4) years tended to describe the eyes as "different," and children aged 5(3/4) years or older almost uniformly gave a negative description of the strabismic dolls. CONCLUSIONS: A negative attitude toward strabismus appears to emerge at approximately 6 years of age. The biopsychosocial determinants of dislike and hostility toward ocular deviations are apparently acquired, learned responses.

Age Factors↗

PubMed2002

In search for increased prevalence rates of strabismus and microstrabismus in two Bavarian districts, Oberpfalz and Niederbayern, to spot populations for gene identification.

PURPOSE: This study was intended to identify communities with an increased prevalence rate of inherited eye diseases (different forms of strabismus, juvenile maculopathy, AMD, myopia magna, etc.) in the districts Oberpfalz (Opf.) and Niederbayern (Ndb.). The data obtained in this study will serve to identify larger families and inbred populations for genetic testing to identify the cause of eye diseases with autosomal recessive and multifactorial inheritance. DESIGN: In cooperation with the local ophthalmologists in two Bavarian districts anonymized lists were compiled correlating diagnosis, postal code, and municipality of strabismus patients. The office software used in the participating practices was a limiting factor as well as the hand-written records used in most of these. The collected data were correlated with the published prevalence rates in the general population. RESULTS: Of the 104 local ophthalmologists who were invited to participate, only 17 provided information. The results indicate an increased prevalence rate of strabismus and microstrabismus patients from Neumarkt (Opf.) / Postbauer-Heng, Amberg, Hauzenberg and Pocking. CONCLUSION: Documentation as it is currently done - local ophthalmologist generally have written records and computer systems that are unsuitable for detailed surveys - restricts the possibility of completing the survey in the whole area. Nevertheless, regional accumulations of strabismus/microstrabismus could be described, providing populations for further investigations to uncover the genetic causes.

Chromosome Mapping↗

PubMed2002

Effect of inferior oblique recession in strabismus sursoadductorius.

UNLABELLED: The aim of this retrospective study was a quantitative analysis of the effect of graded inferior oblique recessions (8 mm, 10 mm or maximal) in strabismus sursoadductorius. METHOD: 234 patients (2-81 years of age) with unilateral strabismus sursoadductorius and stereopsis were operated between 1990 and 1999. Maximal recession (14.6 mm) included an anteroposition to the lateral aspect of the insertion of the inferior rectus. Before and three months after the operation, horizontal and vertical deviations (VD) were assessed by cover testing in five positions of gaze. In 121 patients, additional subjective quantitative assessment, including cyclodeviation measurement, was carried out with Harms' tangent screen. RESULTS: The mean effect of the operation on VD in 25 degrees adduction increased from 6 degrees with 8 mm recession to 10 degrees with maximal recession. It was related more to the amount of preoperative VD in adduction than to the amount of recession. One patient had a limitation of elevation with a hypotropia of >4 degrees, 7% needed further surgery because of undercorrection. DISCUSSION: Maximal recession of the inferior oblique muscle is a suitable procedure even in patients with marked strabismus sursoadductorius. The rate of functional undercorrection is low and there is no risk from general anesthesia or significant postoperative limitation of elevation.

Adolescent↗

PubMed2001

Strabismus surgery in congenital third nerve palsy.

BACKGROUND: Congenital third nerve palsy is a rare condition that usually presents with a large-angle incomitant strabismus and is often associated with ptosis and amblyopia. METHODS: We present the results of strabismus surgery in seven consecutive patients. RESULTS; All the palsies developed before the age of 6 months and the age at surgery ranged from 3 to 24 years. The operations performed included horizontal recti resection/recession (7), supra-placement of the insertions (6), superior oblique weakening (4) and traction sutures (4). The preoperative and postoperative horizontal deviations consisted of seven exotropias and one esotropia due to a combined sixth and partial third nerve palsy. The preoperative vertical deviation consisted of 7 hypotropias and one hypertropia; postoperatively, 5 remained hypotropic and 2 were hypertropic. All patients underwent ptosis surgery. CONCLUSION: Patients with congenital third nerve palsy often achieve reasonable cosmesis with strabismus and ptosis surgery.

Adolescent↗

PubMed2001

Reduction of astigmatism after infancy in children who did and did not wear glasses and have strabismus.

The purpose of this study was to record and explain the changes in astigmatism as normal and strabismic infants grew. Two-hundred-and-eighty-nine hypermetropic infants were randomly allocated to wear glasses from the age of six months. Changes in astigmatism and in hypermetropia of the horizontal and vertical meridia were compared in those who did and did not wear glasses and have strabismus. Mean astigmatism decreased significantly (p < 0.001) in both eyes of normal and strabismic children, but the 'last' astigmatism was significantly (p < 0.001) larger in both eyes of those who had strabismus. There was a similar progressive decrease of hypermetropia in both meridia of both eyes within each diagnostic group, but with the exception of the vertical meridian of the non-fixating eyes (in which the difference approached statistical significance), this was significantly (p < 0.01) larger in the normal children. The consistent wear of glasses was not associated with change in both meridia of both eyes in the normal children (p < 0.005), but had no significant effect on the changes in astigmatism. Since the changes in the two meridia were proportional to the starting level, hypermetropia decreased more in the meridian which was, initially, the more hypermetropic one, and the difference between them, i.e. astigmatism, tended to disappear whether or not the child eventually had strabismus.

Astigmatism↗

PubMed2004

Anterior transposition compared to graded recession of the inferior oblique muscle for V-pattern strabismus.

OBJECTIVE: To compare the efficacy of anterior transposition (AT) and graded recession (GR) in the treatment of V- pattern strabismus caused by overaction of the inferior oblique muscle. METHODS: The charts of surgically treated cases of V-pattern strabismus were analyzed retrospectively and the patients classified as AT or GR. Age, initial horizontal deviation, initial V-pattern and the amount of V-pattern correction were compared between the two groups. RESULTS: There was no significant difference in age (p = 0.066), initial horizontal deviation (p = 0.59), initial V-pattern (p = 0.15) or the amount of V-pattern correction (p = 0.78) between the two groups. CONCLUSION: AT is at least as effective as GR in the treatment of V-pattern strabismus caused by overaction of the inferior oblique muscle.

Adolescent↗

PubMed2005

Does botulinum toxin have a role in the treatment of secondary strabismus?*.

METHODS: We reviewed the Toxin Clinic database over a 20-year period, identifying patients with strabismus secondary to permanent or temporary impairment of vision. RESULTS: Five hundred-and-three patients who fulfilled our criteria were treated with Botulinum toxin. There were 301 males and 202 females, with a mean age at treatment of 35 years (range 6-86). Three hundred-and-eighty-three patients (76%) had exotropia, 114 (22.5%) had esotropia and 6 (1.5%) had vertical strabismus. Reduced vision secondary to trauma accounted for 45% (227) of patients. Other causes were congenital anomalies 121 (24%), refractive error 30 (6%), retinal detachment 20 (4%), senile cataract 24 (5%), corneal problems 19 (4%), glaucoma 10 (2%) and other 52 (10%). One hundred-and-ninety-three (38%) were aphakic. One thousand-four-hundred-and-fifty-seven injections were given, with a range of 1-50 per patient. Ninety-nine (20%) patients were managed with continued toxin treatment. Two hundred-and-eighteen patients (43%) proceeded to surgery. Forty patients (8%) required no further treatment as they regained binocularity by injection alone. CONCLUSIONS: Botulinum toxin appears to have a role in the treatment of secondary strabismus, since only 3% (14) failed to obtain any reduction in their angle. It was well tolerated, with no permanent side effects. Only 22 (4%) patients developed ptosis.

Adolescent↗

PubMed2005

Evaluation of mitomycin C in reducing postoperative adhesions in strabismus surgery.

AIMS: The aim of this study was to evaluate the efficacy of mitomycin C in reducing postoperative adhesions following strabismus surgery. METHODS: This study was a prospective, single-center, interventional case series. We randomized 14 patients with restrictive strabismus to the mitomycin C group (7 patients) or to the control group (7 patients). We used mitomycin C intraoperatively for 5 min at a concentration of 0.2 mg/mL in the mitomycin group after adhesion release. We compared postoperative results using the forced duction test. RESULTS: Compared to the control group, the mitomycin C group exhibited a better range of passive duction at all postoperative follow-up times; however, mitomycin C did not completely eliminate the problem of postoperative adhesions. Patients receiving mitomycin C did not report any complications during this study. CONCLUSIONS: The intraoperative application of mitomycin C is a safe and effective adjunct to surgery in the treatment of restrictive strabismus.

Adult↗

PubMed1992

The antiemetic effect of lorazepam after outpatient strabismus surgery in children.

The high incidence of postoperative emesis after strabismus surgery in pediatric outpatients can be reduced by the prophylactic administration of droperidol 75 micrograms/kg intravenously. However, this may be associated with profound sedation, delayed discharge, dysphoria, agitation, and extrapyramidal symptoms in this population. Because lorazepam used as an antiemetic in children during chemotherapy decreased the incidence of nausea and vomiting, we compared the antiemetic effects of lorazepam and droperidol in a randomized, double-blind, placebo-controlled study of 129 healthy children undergoing surgical correction of strabismus. The children, aged 1-13 yr, were randomly allocated into three groups. The children in group 1 received droperidol 75 micrograms/kg intravenously; those in group 2 received lorazepam 10 micrograms/kg intravenously; and those in group 3 received placebo. Anesthesia consisted of halothane, nitrous oxide in oxygen, and atracurium. Study drugs were administered intravenously after induction of anesthesia but before surgery. In children 3-13 yr old, administration of either lorazepam or droperidol was associated with a lower (P < 0.024) incidence of postoperative vomiting. There was no difference between the antiemetic effect of lorazepam and that of droperidol. The incidence of postoperative agitation was greater in the droperidol group (P < 0.001) than in the lorazepam and placebo groups. Postdischarge vomiting was less (P < 0.009) in children younger than 3 yr of age. Lorazepam, similar to droperidol, has an antiemetic effect in outpatient children 3-13 yr old undergoing strabismus correction, but it is associated with less postoperative agitation than is droperidol.

Adolescent↗

PubMed1998

Low-dose ondansetron with dexamethasone more effectively decreases vomiting after strabismus surgery in children than does high-dose ondansetron.

BACKGROUND: Ondansetron and dexamethasone have been observed to decrease the incidence of vomiting by children after general anesthesia. This study compared the effect of high-dose (150 microg/kg) ondansetron with low-dose (50 microg/kg) ondansetron plus 150 microg/kg dexamethasone on the incidence of vomiting after strabismus in children. METHODS: This study had a double-blind, blocked, stratified, randomized design. With parental consent and Hospital Ethics Committee approval, healthy children aged 2-14 yr who were undergoing elective strabismus surgery were studied. Anesthesia was induced intravenously with propofol or by inhalation with halothane and nitrous oxide. Patients in the high-dose group were given placebo plus 150 microg/kg (maximum dose, 8 mg) of ondansetron intravenously, whereas patients in the low-dose group were given 150 microg/kg dexamethasone (maximum dose, 8 mg) and 50 microg/kg ondansetron intravenously in a double-blind manner. Anesthesia was maintained with halothane and nitrous oxide. All incidences of vomiting occurring as long as 24 h after anesthesia were recorded. RESULTS: Three of the 200 patients enrolled in the study were excluded from data analysis. The groups were similar with respect to demographic data and potential confounding variables. Patients vomited from 0-12 times. The low-dose ondansetron plus dexamethasone group had a lower incidence of vomiting, 9% (95% CI = 4-17%) versus 28% (95% CI = 20-38%; P < 0.001). Only 1% of the patients in the low-dose ondansetron plus dexamethasone group vomited while in the hospital. CONCLUSIONS: Low-dose ondansetron plus dexamethasone is an effective prophylactic antiemetic combination for children undergoing strabismus surgery.

Antiemetics↗

PubMed2000

Prophylactic ondansetron in prevention of postoperative nausea and vomiting following pediatric strabismus surgery: a dose-response study.

BACKGROUND: This study evaluated the antiemetic effectiveness, dose-response, and clinical usefulness of prophylactic ondansetron in the prevention of postoperative nausea and vomiting (PONV) in children undergoing strabismus repair. METHOD: The authors observed 180 children, American Society of Anesthesiologists physical status I or II, 2-12 yr of age, who were undergoing strabismus repair. After induction of anesthesia with halothane and nitrous oxide in oxygen or intravenous thiopental, children received either placebo (saline) or intravenous ondansetron in doses of 25, 50, 75, 100, and 150 /microg/kg (n = 30). The trachea was intubated and ventilation was controlled. Perioperative analgesic and fluid requirements were standardized. Episodes of nausea and vomiting were recorded for the first 24 h postoperatively. Data such as nonsurrogate (parental satisfaction scores and duration of postanesthesia care unit stay) and therapeutic (numbers needed to prevent and harm) outcome measures were collected. RESULTS: The incidences of PONV in the placebo and 25-, 50-, 75-, 100-, and 150-,microg/kg ondansetron groups were 83, 77, 47, 30, 30, and 27%, respectively. The incidence was less in the 75(P = 0.002), 100- (P = 0.002), and 150-microg/kg (P < 0.001) ondansetron groups compared with placebo. Duration of stay in the postanesthesia care unit was shorter in the 75-, 100-, and 150-microg/kg ondansetron groups (P < 0.002) compared with the placebo group. Parental assessment scores for the child's perioperative experience and the positive number needed to prevent PONV were also better and favorable in the 75-, 100-, and 150-microg/kg ondansetron groups compared with the placebo group. The incidence (P > 0.99) and severity (P = 0.63) of PONV were similar in the 75- and 150-microg/kg ondansetron groups. Surrogate, nonsurrogate, and therapeutic outcome measures revealed that 75 microg/kg ondansetron provided the same benefits as did 100 and 150 microg/kg. CONCLUSION: The routine prophylactic use of ondansetron at a dose of 75 microg/kg is as effective as 150 microg/kg in preventing PONV and improving the "true" outcome measures after strabismus repair in children.

Anesthesia, General↗

PubMed2005

Inspired oxygen fraction of 0.8 does not attenuate postoperative nausea and vomiting after strabismus surgery.

BACKGROUND: Postoperative nausea and vomiting (PONV) is a distressing problem after strabismus surgery. An inspired oxygen fraction has been reported to decrease PONV in patients after colon resection and to be more effective than ondansetron after gynecologic laparoscopy. Therefore, in a randomized, prospective, placebo-controlled study, the authors tested whether an inspired oxygen fraction of 0.8 decreases PONV in patients undergoing strabismus surgery and whether oxygen is more effective than ondansetron. METHODS: With approval of the authors' institutional review board, 210 patients were randomly assigned to receive one of three treatments: (1) 30% inspired oxygen in air plus intravenous administration of saline, (2) 80% inspired oxygen in air plus intravenous administration of saline, or (3) 30% inspired oxygen in air plus 75 microg/kg ondansetron intravenously during induction. General anesthesia was standardized and included etomidate, alfentanil, and mivacurium for induction and sevoflurane for maintenance. PONV was evaluated 6 and 24 h postoperatively by an investigator unaware of treatment assignment. RESULTS: Overall postoperative incidence of nausea and vomiting was 41% for inspired oxygen fraction of 0.3 plus placebo, 38% for inspired oxygen fraction of 0.8 plus placebo, and 28% for inspired oxygen fraction of 0.3 plus ondansetron, respectively (P = 0.279). Therefore, there was no statistically significant difference of PONV incidence among groups. CONCLUSIONS: An inspired oxygen fraction of 0.8 during general anesthesia with sevoflurane does not decrease PONV in patients undergoing strabismus repair. Ondansetron also did not significantly decrease PONV in our study setting.

Adolescent↗

PubMed1993

Sensitive period in stereopsis: random dot stereopsis after long-standing strabismus.

Bifoveal fixation is a requirement for random dot stereopsis. It is believed that random dot stereopsis is not possible after treatment of long-standing strabismus because binocular cortical cells are permanently damaged when strabismus is present during the sensitive period. Although the sensitive period for amblyopia has been clearly documented, the sensitive period for stereopsis is uncertain. We present a case we have followed from age 22 months to 10 years. This patient had intermittent esotropia until approximately age 3 years 4 months; he then had constant esotropia from about age 3 years 4 months to age 9 years 7 months. After orthoptic treatment at age 9 years, the patient returned to intermittent esotropia. He subsequently developed bifoveal fixation as measured by 30 sec arc of contour stereopsis and 250 to 500 sec arc of random dot stereopsis. This patient demonstrates that bifoveal fixation can be obtained after long-standing strabismus. We suggest that the sensitive period for stereopsis development, for this patient, was from birth to age 3 years.

Aging↗

PubMed1995

Brain pathology and strabismus.

If we consider the complex and articulate organization of the oculomotor neural system, ie, infranuclear, nuclear, internuclear, and supranuclear levels, how many neuronal structures are implicated and their widespread localization in the central nervous system, and if we understand the various relationships within the oculomotor system and with other cerebral structures, we may easily realize that cerebral diseases and oculomotor disturbances are tightly and reciprocally connected. Many diseases may be associated with ocular movement impairment, sometimes acting on different sites of oculomotor organization. These alterations may have a clear pathophysiologic meaning and a relevant topographic localizing value, otherwise correlations and mechanisms are simply hypothetical. Last but not least for conceptual relevance are the modifications of neuronal anatomy and physiopathologic mechanisms induced by the strabismus. In the past year many articles have been published that analyze the relationships and the pathogenetic role of cerebral anomalies in the context of strabismus syndromes. Of outstanding interest is the proof of cortical and subcortical neural stations' plasticity, and the evidence of a cerebral anatomophysiologic basis of strabismus and amblyopia. In this context the midbrain, pontine, and brain stem nuclei and neuronal organizations have a peculiar importance. We will try to systematically expose, even if briefly, the main contributions in this area.

Brain↗

PubMed1996

Comitant strabismus.

Comitant strabismus has been investigated and treated for centuries. Advances in understanding the etiology of this disorder have improved our ability to successfully treat it. This article addresses recent insights into the causes and treatments of comitant strabismus, with a focus on congenital esotropia, intermittent exotropia, and adult strabismus.

Adult↗

PubMed1998

Paralytic strabismus.

The use of sophisticated imaging techniques has led to a greater understanding of the mechanisms of some forms of strabismus. In particular, studies of strabismus in high myopia have demonstrated abnormal muscle courses and provided a basis for corrective surgery. Although injection of botulinum toxin has a place in modern strabismus management, there have been few controlled studies validating its use. An important paper in the review period directly compares botulinum with surgery to confirm its effectiveness for at least one indication.

Animals↗

PubMed1999

Comitant strabismus.

This year's review of the literature on comitant strabismus is presented. The main problems in treating strabismus disorders are accurately diagnosing the condition and designing effective treatment plans. A better understanding of the underlying motility disorder facilitates a better treatment outcome. Several of this year's papers address the better detection and identification of comitant strabismus. Some patients with comitant exotropia and esotropia, however, have superimposed incomitant motility patterns such as dissociated vertical deviation. New insights into the possible etiology of dissociated vertical deviation have emerged through use of the sophisticated scleral search coil technique, which permits the discovery of minute motility changes not visible to the clinician's eye. The same technique was used to clarify the traditional clinical experience that convergence insufficiency can improve with convergence exercises.

Eye Movements↗