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PubMed2004

[Fixation in patients with anisometropic amblyopia without strabismus].

PURPOSE: To determine the type of fixation in patients with anisometropic amblyopia without strabismus and find correlation between amount of anisometropia and eccentricity of fixation. MATERIAL AND METHODS: 100 patients with anisometropic amblyopia without strabismus were examined. The following data was obtained: visual acuity, type of fixation, refraction error after cycloplegia. Amount of anisometropia was calculated as the difference of spherical equivalents. RESULTS: Only 44% of patients demonstrated central fixation. The amount of amblyopia corresponded to eccentricity of fixation. For most cases (anisometropia up to 6D of SE) the amount of anisometropia did not correlate with eccentricity of fixation. CONCLUSIONS: Simply difference of refraction must not be the only factor affecting development of anisometropic amblyopia.

Adolescent↗

PubMed1992

Sub-Tenon's infusion of local anesthetic for strabismus surgery.

We used a blunt irrigating cannula to infuse tetracaine 0.5% solution into the posterior sub-Tenon's space in 26 consecutive patients undergoing strabismus surgery under local anesthesia. All patients were sedated with combinations of fentanyl citrate and either propofol or midazolam. The results suggest that this technique is a safe and effective method of performing strabismus surgery under local anesthesia.

Adolescent↗

PubMed1992

[Droperidol versus metoclopramide. Prevention of emesis following strabismus surgery in children].

Vomiting after strabismus surgery is a major problem that remains as yet unsolved, especially in children. Droperidol and metoclopramide, both known as powerful antiemetic drugs, were compared in this study. METHODS. One hundred ASA class I and II children ranging from 3 to 10 years of age were studied in a double-blind, randomised fashion. They were assigned to three groups: group D (n = 33) received 0.075 mg/kg droperidol, group M (n = 33) 0.15 mg/kg metoclopramide, and group N (n = 34) 0.1 ml/kg NaCl i.v. upon arrival in the post-anaesthesia recovery room (PARR). After oral premedication with 0.4 mg/kg midazolam, anaesthesia was induced via a face mask by inhalation of halothane, nitrous oxide, and oxygen. Barbiturates, atropine, and succinylcholine were not used; 0.05 mg/kg vecuronium was given to facilitate intubation. Gastric contents were aspirated by a gastric tube at the end of the operation. Vomiting and retching were recorded for 24 h; recovery from anaesthesia was assessed by a modified Steward score. RESULTS. The three groups were comparable regarding age, body weight, duration of anaesthesia, number of repaired eye muscles, and occurrence of the oculocardiac reflex (OCR). During the first 24 h postoperatively 21/33 (64%) patients of group D vomited, 24/33 (73%) of group M, and 33/34 (97%) of group N. The differences between groups D and N and between M and N were significant (P less than 0.01); comparison of groups D and M showed no statistical significance. Droperidol was more effective in reducing severe vomiting. Of the group N children, 47% vomited more than 6 times in 24 h compared to 18% of group M and 0% of group D. Age, sex, duration of anaesthesia, number of repaired eye muscles, and occurrence of the OCR had no influence on postoperative vomiting. Despite being administered at the end of the operation, droperidol did not prolong the patients' stay in the PARR. The post-anaesthetic scores for group D children were only slightly lower compared to groups M and N. CONCLUSIONS. Droperidol (0.075 mg/kg) and metoclopramide (0.15 mg/kg) both reduce postoperative vomiting after strabismus surgery. Droperidol seems to be more effective in reducing severe vomiting. Postoperative sedation after droperidol was not a major problem in our experience.

Child↗

PubMed2005

[Amblyopia and strabismus in our environment].

PURPOSE: This study aimed to identify the characteristics of amblyopia in a group of strabismic patients in our environment in order to improve management. METHODS: A prospective study was carried out in the General Hospital, Douala, from July 1991 to July 2003. All strabismic patients had a complete ophthalmological examination including an oculomotor evaluation and skiascopy after cycloplegia. RESULTS: 330 patients were examined. The mean age at initial consultation was 13.97 years +/- 12.21. The prevalence of amblyopia was 80.46% in esotropia and 59.40% in exotropia. The precocity of strabismus, eccentric fixation, torticollis, presence of a vertical element and nystagmus were aggravating factors for amblyopia. CONCLUSION: In order to carry out early and coherent management of strabismus, it is important to train and inform all those who are involved in the care process.

Adolescent↗

PubMed2005

[Changes of the structure of neuronal connections in visual cortex of cats with experimentally induced bilateral strabismus].

The spatial distribution of neuronal connections in cortical area 17 in cats with bilateral convergent strabismus, surgically induced on postnatal days 10-14, was investigated. Single cortical columns of areas 17 and 18 were microiontophoretically injected with horseradish peroxidase and retrogradely labeled cells in both hemispheres were detected. The intrahemispheric connections in area 17 along the mediolateral direction (the projection of visual field horizontal meridian) were found to be either dilated or reduced. For most columns, the interhemispheric connections in this direction were increased, which may provide for more reliable unification of two visual hemifields. Moreover, the extension of intra- and interhemispheric connections in rostrocaudal direction (along the visual field vertical meridian projection) was detected in some cortical columns. Thus bilateral strabismus induced during the developmental critical period, modifies the structure of both of intra- and inter-hemispheric spatial neuronal connections of individual cortical columns in areas 17 and 18.

Animals↗

PubMed2006

The 10th Bielschowsky Lecture. Changes in strabismus over time: the roles of vergence tonus and muscle length adaptation.

Patients with long-standing unilateral strabismus, such as "sensory" exotropia in the absence of fusion, or esotropia with unilateral amblyopia, typically show bilateral deviations under anesthesia, often symmetric. Forced ductions usually show symmetric muscle tightness. Changes in extraocular muscle lengths thus appear to occur primarily bilaterally, whether fusion is present or not. With skeletal muscles responding to changes in stimulation by the gain or loss of sarcomeres, it is likely that abnormal or unguided vergence tonus, which changes the lengths of the extraocular muscles bilaterally, is largely responsible for changes in the angle of strabismus over time. This mechanism helps explain the development of [1] increasing "basic" deviations in accommodative esotropia; [2] torsional deviations with apparent oblique muscle "overaction/underaction" and A and V patterns; [3] recurrent esotropia with early presbyopia; [4] occasional divergence insufficiency in presbyopes; and [5] basic cyclovertical deviations that mimic superior oblique muscle paresis.

Adaptation, Ocular↗

PubMedDate not supplied

Infection following strabismus surgery.

Sixty-three strabismus surgeons were surveyed regarding the incidence of infection they found following strabismus surgery and their use of preoperative and postoperative antibiotics to prevent or treat such infections. Cellulitis was rare (1 per 1,900 cases) and endophthalmitis was even rarer (1 per 30,000 cases). Infection was not entirely prevented by either preoperative or postoperative topical antibiotics. Twelve surgeons reported using no antibiotics but did not report higher rates of infection than those who did use them.

Anti-Bacterial Agents↗

PubMed1991

Infection following strabismus surgery.

Sixty-three strabismus surgeons were surveyed regarding the incidence of infection they found following strabismus surgery and their use of preoperative and postoperative antibiotics to prevent or treat such infections. Cellulitis was rare (1 per 1900 cases) and endophthalmitis was even rarer (1 per 30,000 cases). Infection was not entirely prevented by either preoperative or postoperative topical antibiotics. Twelve surgeons reported using no antibiotics but did not report higher rates of infection than those who did use them.

Anti-Bacterial Agents↗

PubMed1990

[The surgical characteristics of ptosis in the Marcus Gunn syndrome combined with strabismus].

The paper contain criteria for the choice of the character and dosage of surgical intervention in treatment of children with the Marcus-Gunn's syndrome and strabismus. As a basis, the following conditions are assumed: the state of the motility of the patient's eye upwards, the angle of strabismus, the state of corneal sensitivity, the degree of ptosis in the state of rest and activation of facial expression. Considering the mentioned conditions, 14 children were operated on, predominantly at the age from 2 to 5 years. Repeated resection of the levator was made in 2 children because of hypoeffect. In all children the final result was satisfactory, no complications were observed.

Blepharoptosis↗

PubMed1990

[Symptomatologic value of dissociated vertical divergence in concomitant strabismus].

D.V.D. is an opto-motor anomaly which is likely starting from the retina. D.V.D. is seldom isolated and it is most often found in congenital strabismus or in early onset strabismus (with or without alterared fusion) with an horizontal deviation most often associated with a vertical syndrome. The clinical assessment of D.V.D. is of major importance in the pre and post-operative examination. The simultaneous horizontal and vertical surgery reduces the amplitude of D.V.D by re-establishing a central or peripherical fusion.

Humans↗

PubMedDate not supplied

[Functional study in early strabismus: translucent screens and electro-nystagmography].

The symptoms of infantile strabismus are triggered by fixation, chiefly monocular fixation. On the excluded eye, "occlusion deviations" (elevation, esodeviation, extorsion) are well observed through a "translucent" unilateral cover. These deviations are super-imposed upon a position of rest without fixation which may be an orthoposition, well observed through bilateral translucent occluders. They are caused by a rupture of binocular retinal stimuli which does not mean rupture of fusion (ex: the darkening Bielschowsky test). Electro-oculographic studies confirm the prevalence of adduction during fixation (nystagmus, pursuit, optokinetic nystagmus). This directional asymmetry is typical of the infant's immature system of fixation. In infantile strabismus, it persists because of missing binocular links (corpus callosum--cortex----midbrain) as shown by the study of the so-called congenital monophthalm syndrome (unilateral congenital blindness).

Child↗

PubMed1990

[The prevalence of refractive, anisometropic amblyopia in adults without strabismus and with contact lens correction].

The paper presents results after examination of 1260 adults (2547 eyes), aged from 18 to 55 years, for the period from 1982 to 1988. The examination was carried out in order to reveal the incidence of refractive, anisometropic amblyopia without strabismus in persons using glasses (a control group) and contact lenses as well as to determine a degree of spheric, astigmatic refraction in development of amblyopia on the background of contact lenses. It was found that amblyopia on the background of contact correction, as compared with glass correction, develops rarer making up 22.03% of them low degree of amblyopia is recorded in 51,16%, moderate--in 35,65% high--in 13,19% to the total number of amblyopic eyes examined. Direct relationship between the number of amblyopic eyes and degree of astigmatism and anisometropia is revealed. Detection of amblyopia in adults without strabismus with subsequent contact correction and treatment is considered to be necessary for medical and labour rehabilitation of such patients.

Adolescent↗

PubMed1990

[Strabismus and stereopsis].

104 strabismic patients successfully corrected surgically were followed up for 6 months to 13 years, averaging 2 1/2 years, and 55 obtained final stereopsis. These results suggest that early strabismus surgery is important in establishing stereopsis. Furthermore, the younger he onset of strabismus, the poorer are the chances of building up stereopsis, and congenital cases have the poorest prognosis.

Adolescent↗

PubMed1989

[Acute strabismus caused by accommodative spasm].

Acute strabismus accommodative spasm about an adult. A 17 years old woman presents an acute strabismus with accommodative spasm. The different diagnostics and treatments are evoked.

Accommodation, Ocular↗

PubMed1989

Adjustable sutures in strabismus surgery.

The benefits of the adjustable suture technique for strabismus surgery include the surgeon's ability to place the eye at the exact position desired in the immediate postoperative period. Depending on the type of deviation, this may be orthophoric, slight esophoric, or slight exophoric. Unexpected postoperative results are prevented which can occur when measurements and classical surgery are done in special problems such as paretic and restrictive strabismus and in reoperations. In addition precise alignment can be made in patients with weak fusion or fusion only in certain fields of gaze, and this should decrease the need for reoperation.

Adolescent↗

PubMed1977

Day case surgery for strabismus in children.

A consecutive series of 140 children was observed after strabismus surgery. All the postoperative problems are attributable to general anaesthesia, vomiting and drowsiness being the principal ones. Respiratory difficulties were unusual. There is no reason to keep a healthy child in hospital for longer than one night, and day case strabismus surgery appears to be safe if (1) an experienced doctor gives the anaesthetic, (2) there is adequate supervision for 3 to 4 hours after surgery, (3) the appropriate district nurse is forewarned that a child is returning home after general anaesthesia, and (4) facilities are available to retain a child in hospital if a problem arises before discharge. Signs of emotional trauma may be less in children treated as day cases than in those hospitalized for one or more nights.

Adolescent↗

PubMed1979

Lens dislocation after strabismus surgery.

A case of lens dislocation complicating strabismus surgery is described. This complication following scleral perforation is extremely rare. The lens dislocation occurred in the direction of the connective tissue overlying the perforation site to which multiple cryoapplications had been made. Irrigation and aspiration of the clear lens followed by discission of the lens capsule was necessary because of progressive lens dislocation resulting in profound amblyopia. Accurate aphakic optical correction of the involved eye combined with vigorous occlusion of the fellow eye resulted in excellent visual acuity for both eyes. Cosmetic strabismus surgery was then performed. Continued intermittent occlusion of the fellow eye, combined with continued constant aphakic optical correction of the affected eye will be required. The affected eye will be carefully followed for the long-term complication of retinal detachment associated with connective tissue traction.

Amblyopia↗

PubMed1988

[Experience in the early detection of strabismus in child day care centers. Value in the prevention of amblyopia in young children].

A screening for early detection of strabismus in infants and young children attending day care centers in the town of Lyons was conducted during one year (1986): 838 children (3 month to 3 year old) were screened. A defective vision was found in 17 children (2%). Such early screening of strabismus, easy to realize and well accepted by the parents, is of great interest since it allows early detection and treatment with a maximum chance of complete recovery before starting primary school.

Amblyopia↗