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At least 793 records · Page 44Linked to original sources

PubMed2000

Impact of large angle horizontal strabismus on ability to obtain employment.

OBJECTIVE: To determine if large angle esotropia and exotropia could impact a person's ability to obtain employment. DESIGN: Laboratory experiment. PARTICIPANTS: Seventy-nine respondents unaware of the purpose of the study. METHODS: Photographs of two men and two women were digitally altered to create photographs of the same individual in an orthotropic, esotropic, and exotropic state. The photographs were then randomly affixed to similarly qualified job resumes. The 79 study respondents, unaware of the purpose of the study, were asked to (1) rate each individual applicant on selected job qualification variables, and (2) rank the applicants against each other in order of hiring preference. MAIN OUTCOME MEASURES: Individual applicant rating and hiring preference scores. RESULTS: Women with normal ocular alignment received greater hiring preference scores than did strabismic women (P = 0.007). No difference in hiring preference scores was noted between strabismic and non-strabismic male applicants (P = 0.47). CONCLUSIONS: Large angle horizontal strabismus appeared to be vocationally significant for female applicants, reducing a strabismic female applicant's ability to obtain employment. The presence of strabismus did not appear to influence hiring decisions of male applicants.

Adult↗

PubMed2000

Strabismus surgery in children with Möbius syndrome.

Möbius syndrome is a congenital disorder of facial diplegia associated with lateral gaze paralysis. Although palsy of the sixth and seventh cranial nerves is the minimum diagnostic finding for Möbius syndrome, neuropathologic evidence indicates that this is a more complex syndrome.(1) Clinically, it is characterized by a total absence of facial expression and severe esotropia. Other anomalies may be associated with this syndrome, especially other cranial nerve palsies and Poland syndrome. The etiology of this syndrome has not been clearly established. Brain stem necrosis resulting from a vascular deficiency has been offered as a possible pathogenetic explanation.(2) The strabismus in Möbius syndrome is congenital esotropia with bilateral limitation in abduction. Even though many reports have described the various features of Möbius syndrome, only a few articles have reported the results of strabismus surgery in children, including bimedial rectus muscle recession. (3-5) Some authors report that bilateral medial rectus muscle recession alone has been disappointing; therefore, a combination of a medial rectus muscle recession and a lateral rectus muscle resection was recommended for satisfactory results. (5-7) In more severe cases, muscle transposition was needed to ensure straight position of the eyes in primary gaze. (8-9)

Esotropia↗

PubMed1999

Combined resection and recession of a single rectus muscle for the treatment of incomitant strabismus.

BACKGROUND: The treatment of incomitant strabismus is challenging. Traditional approaches include the use of asymmetric bilateral surgery and the fadenoperation (posterior fixation suture). We report our experience with a different approach: combined resection and recession of a single rectus muscle. METHODS: The charts of 12 patients who underwent resection of a single rectus muscle with an equal or greater amount of recession of the same muscle were identified. In 5 patients, the procedure was performed using the adjustable suture technique, and the adjustment was performed later the same day (Group 1). In the remaining 7 patients, permanent sutures were placed at the time of surgery (Group 2). The procedure was performed for horizontal and vertical gaze incomitance, dissociated horizontal deviation, and distance-near disparity. RESULTS: Four of the 5 patients in Group 1 showed stable, long-term correction of their incomitance, both in primary gaze and in gaze in the direction of the muscle operated on. The results for patients in Group 2 showed stable, long-term correction of incomitance in 3 patients; however, these patients also had slight overcorrections in the direction of gaze opposite to the muscle operated on. An additional patient in Group 2 had a shift of her distance-near disparity, shifting from relatively exotropic to relatively esotropic disparity postoperatively. All patients in Group 2 showed at least some decrease in the amount of measured incomitance. We did not encounter complications such as muscle slippage or loss, scleral perforation, or late overcorrection in the field of gaze of the operated muscle. CONCLUSIONS: The technique of combined resection and recession of a single rectus muscle shows promise in the treatment of incomitant strabismus. It offers the advantages of posterior fixation combined with the greater technical ease of a standard hangback recession. The muscle may also be placed on an adjustable suture, allowing for postoperative adjustment in selected patients.

Adolescent↗

PubMed2006

Filamentary keratopathy caused by corneal occlusion by large-angle paralytic strabismus.

PURPOSE: To report a case of filamentary keratopathy in a patient with large-angle paralytic strabismus. METHODS: A 31-year-old man who had a traffic accident was diagnosed to have third cranial nerve palsy and a large-angle exotropia in his right eye. The patient complained of foreign body sensation in his right eye 2 months after the accident. RESULTS: Slit-lamp examination showed multiple filaments on the right cornea. Debridement of the filaments and artificial tears relieved the symptoms and were used until the paralysis resolved. CONCLUSION: Large-angle paralytic strabismus with ptosis and poor elevation and depression of the eye may occlude the cornea and lead to filamentary keratopathy.

Accidents, Traffic↗

PubMed2000

Comparative study of brain lesions detected by magnetic resonance imaging between strabismus and nonstrabismus in infancy.

PURPOSE: To elucidate the causative factors in infantile esotropia, we evaluated morphological abnormalities in brain structures of esotropia patients showing any abnormal neurological signs in comparison to those of normal controls. METHODS: Sixty-five developmentally normal children participated in this study. Of these 65, 38 demonstrated infantile esotropia and 27 were normal controls. All underwent magnetic resonance imaging (MRI) of the brain between 2 and 30 months. RESULTS: Abnormal brain findings were noted in 3 (7. 9%) children in the strabismus group, whereas none of the children in the normal control group showed brain lesions. In these 3 cases, brain lesions involved periventricular leukomalacia, enlargement of the lateral ventricles with hypoplasia of the corpus callosum and myelination delay at the anterior horn adjacent to the lateral ventricles. CONCLUSIONS: Brain lesions that may disturb normal maturation of the visuomotor system and eventually lead to strabismus could be found in some patients without any episode that would cause birth injury.

Arachnoid Cysts↗

PubMed2004

Ocular dominance column width and contrast sensitivity in monkeys reared with strabismus or anisometropia.

PURPOSE: To study the relationship between the width of ocular dominance columns in primary visual cortex and spatial contrast sensitivity functions in monkeys with strabismus or anisometropia during infancy. METHODS: Adult monkeys having had monocular visual abnormalities induced in infancy were tested behaviorally for spatial contrast sensitivity and then subjected to functional enucleation of one eye to reveal the ocular dominance columns (ODCs) of the primary visual cortex by cytochrome oxidase (CO) staining. The relative widths of the left and right eyes' ODCs were measured and related to the contrast sensitivity functions. RESULTS: The relative widths of the ODCs having input from eyes with strabismic or anisometropic amblyopia were reduced in proportion to the age of onset and the duration of the early visual abnormality. The relative losses in contrast sensitivity were in ordinal agreement with the losses in relative width of the ODCs. CONCLUSIONS: Amblyopia induced by the early monocular abnormalities of strabismus or anisometropia is proportional to the loss in cortical afference as reflected in the reduction in width of the respective ODCs in the primary visual cortex.

Amblyopia↗

PubMed1990

Vergence movements in comitant strabismus.

Vergence movements induced by base-out prisms were recorded, with an infrared eye tracker, for 6 patients with comitant esotropia (i.e., convergent strabismus) and anomalous retinal correspondence and for 6 normal subjects. Vergence movements of strabismic subjects were much slower and showed characteristics different from those of controls. It may be argued that vergence movements are induced by disparity and represent the motor fusion component left over in strabismus. In fact, in this study accommodative as well as proximal vergence had been ruled out. Therefore, the movements recorded can be considered the objective representation of the well-known phenomenon of prism compensation or adaptation, found in many strabismic patients.

Accommodation, Ocular↗

PubMed2005

Change of eye position in patients with orthophoria and horizontal strabismus under general anesthesia.

We studied the relationship between eye position in the awakened state and in the surgical plane of anesthesia in orthophoric and horizontal strabismus patients. We classified 105 orthophoric and horizontal strabismus patients into 5 groups, measured the eye position at the primary position by photographic measurement of the corneal reflex positions and undertook a quantitative study of eye position. Under general anesthesia, the mean divergence was 39.7+/-8 PD for the esotropia group, 36.6+/-11.7 PD for exophoria, 27.4+/-8.1 PD for orthophoria, and 11.1+/-10.2 PD for exotropia I (< or =30 PD). Therefore, the esotropia group had the largest amount of divergence among the groups, but the eye position of the exotropia II (>30 PD) group was rather convergent at 11.0+/-6.5 PD. According to the eye position of the fixating and nonfixating eyes in the esotropia group, both eyes converged with an angle deviation of 14.4+/-4.8 PD divergent and 14.1+/-4.8 PD divergent, respectively (P=.71). In the exotropia groups (I, II), the fixating eye diverged but the nonfixating eye rather converged. Therefore, the angle deviation was 19.0+/-2.1 PD divergent for the fixating eye and 18.2+/-6.4 PD divergent for the nonfixating eye (P=.68). In conclusion, under general anesthesia, eye positions in the awakened state and in the surgical plane of anesthesia were convergent or divergent, and showed a tendency to converge into the position of 25-35 PD divergent. Therefore, we could not distinguish fixating eye from nonfixating eye under general anesthesia.

Adolescent↗

PubMedDate not supplied

The surgical correction of paralytic strabismus using fascia lata.

OBJECTIVE: To present the results of a new technique designed to restore and maintain alignment, exclusively in the primary position, in patients with paralytic strabismus. METHODS: In five patients (seven eyes, total) with exotropia secondary to third-nerve palsy, we fixated the globe with a strip of fascia lata sutured onto both the medial aspect of the eye and the nasal bone periosteum. We characterized the ocular deviation in the primary position with prism diopters the day before the operation, during the initial 24-hour period, and at subsequent monthly postoperative evaluations. We documented all evaluations with photographs. RESULTS: In all patients, the ocular position improved with the surgery. No further change of the ocular position was noted during the follow-up period, which ranged from 15 to 35 months (mean follow up 22.5 months). All the patients tolerated the collagenous tissue without complications. CONCLUSIONS: This procedure can be a useful addition to the current surgical techniques for management of strabismus secondary to third-nerve paralysis.

Adolescent↗

PubMedDate not supplied

Strabismus surgery using the adjustable suture technique.

BACKGROUND AND OBJECTIVE: To determine the results of adjustable suture technique used in horizontal muscle surgery. MATERIALS AND METHODS: Seventy-eight charts of patients who underwent strabismus surgery between the years 1993 and 1995 were examined retrospectively. The study included 35 cases of esotropia (ET), and 43 cases of exotropia (XT). The results of strabismus surgery were measured and compared 1 day after adjustment; the final results between 6 and 24 months after the surgical procedure. RESULTS: Adjustment was required in 39% of all patients. The highest rate of adjustment was required in patients who underwent monocular surgery for XT (51%), and the lowest rate of adjustment was undertaken in patients who underwent monocular surgery for ET (16%). Mean changes in the angle of deviation between 1 day after surgery to the last follow up was 2.2 prism diopters (delta) (+/-11.2 delta) for cases of esotropia, and 4.6 delta (+/-8.7 delta) for exotropia. The most significant drift was found in patients with XT who underwent binocular surgery 6.8 delta (+/-0.9 delta) and the smallest drift was found in patients with ET who underwent binocular surgery 5.2 delta (+/-5.6 delta). CONCLUSION: Esotropic and exotropic patients have a tendency to drift towards their original deviation postoperatively. It is possible, therefore, that mild overcorrection in the early postoperative period will result in better long-term results.

Adolescent↗

PubMedDate not supplied

Large-angle strabismus and primary true muscle transplantation.

BACKGROUND: Large-angle strabismus often demands a series of surgeries to achieve satisfactory alignment. This often necessitates bilateral surgery, which patients may be reluctant to undergo. METHODS: Three patients with large-angle esotropia, not amenable to standard recession and resection procedures, underwent primary true muscle transplantation wherein a fragment of resected extraocular muscle was used to elongate the medial rectus muscle. RESULTS: Postoperative deviation was within +/- 10 PD of orthophoria and was maintained at follow-up of 6 to 12 months. There was mild underaction of the weakened muscle. CONCLUSION: True muscle transplantation is a good option because it permits correction of large-angle strabismus with two-muscle surgery, provides a satisfactory cosmetic alignment, and appears safe and predictable.

Adult↗

PubMed1991

[Heritability of strabismus convergens with exophthalmos in cattle].

Six pedigrees including 107 animals of the breed German Brown Swiss were available to test for a single gene conditioning for convergent strabismus with exophthalmus. The regressive logit models of the segregation analysis showed that a major gene model with additively acting genes explained the segregation of affected animals in the pedigrees in the best way. Additionally, polygenic and environmental effects might be of importance in the occurrence of convergent strabismus with exophthalmus.

Animals↗

PubMed1995

[Computed tomography findings in convergent strabismus fixus].

X-ray computed tomography (CT) of the eyeball and orbit revealed the cause of eye movement disorder in convergent strabismus fixus. The findings suggest that the disease can be diagnosed and treated at an early stage. Twelve cases of progressive esotropia with high myopia and 20 cases with normal visual acuity served as subjects in this study. The CT slice was parallel to the German horizontal plane, and the lens and medial and lateral rectus muscles were scanned. The average axial length of the affected eyes was significantly longer than in normal eyes. In progressive esotropia, the characteristic CT findings are an elongated eyeball, mechanical contact between the eyeball and lateral wall of the orbit, and a downward displacement of the lateral rectus muscle. Thus, it is reasonable to conclude that eye movement disorder in convergent strabismus fixus results from weakness of the lateral rectus muscle which has been displaced downward due to compression of the eyeball against the orbital wall.

Aged↗

PubMed1989

Strabismus surgery for neurological illness. The Stevens Commission 1887-1889.

In 1887, the New York Neurological Society appointed a committee of distinguished neurologists to investigate the claim of ophthalmic surgeon George Thomas Stevens that he could cure chorea and epilepsy through correction of refractive errors and strabismus. After 2 1/2 years, the supervised therapeutic trial collapsed amid mutual recriminations. The commission issued a bland statement to the effect that the treatment was not curative and was insufficiently helpful to recommend. The idea of ocular reflex causation and surgical cure of "neuroses" persisted for several more decades in the face of increasing skepticism and resistance.

History, 19th Century↗

PubMed1975

Polyglycolic acid suture in strabismus surgery.

Polyglycolic acid, synthetic, absorbable braided suture was compared to gut with respect to handling, strength, and tissue reaction in 70 strabismus procedures. This new suture material produced less tissue reaction than gut and had handling characteristics that were similar to silk. It can be used in smaller sizes than gut because of its greater strength and firm knot. Polyglycolic acid suture appears to be a useful addition to ophthalmic suture materials.

Absorption↗

PubMed1976

Past pointing in comitant strabismus.

Faulty egocentric localization or "past pointing" has been reported in the literature only in association with paralysis or paresis of extraocular muscles, or mechanical restrictions of the globe. A case of past pointing associated with comitant strabismus, without evidence of extraocular muscle paralysis, paresis, or restriction is presented. This is believed to be the first reported case of past pointing in a patient with a comitant deviation.

Adolescent↗

PubMed1979

Vertical mattress suture for strabismus resection operation.

The suturing technique for strabismus resection has been simplified with the use of a single double-armed suture in the form of a vertical mattress. Synthetic ophthalmic suture material has made this technique still more desirable because of the tensile strength and tissue-gripping characteristics of these materials.

Humans↗

PubMed1982

Effect of needle characteristics in strabismus surgery.

In strabismus surgery, the characteristics of the needle will affect the length and depth of the scleral bite. In comparing the needle curve, it was found that the acute curve will produce a significantly shorter bite but of equal depth when compared with the needle with a shallow curve. In comparing the effect of the point at the needle, it was found that the needle with the point at the bottom of the needle will produce a bite of equal length but significantly deeper when compared with a needle with the point at the top.

Animals↗