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 91 records · Page 5Linked to original sources

PubMed1980

Strabismus in ptosis.

Two hundred twenty-six consecutive surgical ptosis cases were carefully evaluated to establish the incidence of strabismus in ptosis. The overall incidence of strabismus in surgical ptosis patients was found to be 36%. Most remarkable were the findings in 113 congenital ptosis patients; 32% of these patients were found to have strabismus. Only 44% of these patients had entities previously described associating strabismus with ptosis. It is postulated that in four of the congenital ptosis patients (3.5%), strabismus developed as a result of their ptosis. In one of these patients, strabismus and amblyopia developed while the patient was being observed prior to ptosis surgery. This study demonstrates the need for careful ocular motility evaluation in all patients with ptosis. Ocular motility evaluation and follow-up is especially important in congenital ptosis, where the ptotic lid may, in fact, precipitate strabismus and amblyopia.

Adolescent↗

PubMed1995

Self-assessment of angles of strabismus with photographic Purkinje I and IV reflection pattern evaluation.

BACKGROUND: Accurate assessment of the angle of strabismus, e.g. of variable angles of strabismus, is crucial in preoperative patient management and is usually performed in a clinical environment. Objective assessment by patients themselves, under everyday conditions, could contribute to a better preoperative work-up. A new objective evaluation procedure for the measurement of manifest angles of strabismus for near and distance fixation by the patient himself is presented. METHODS: To account for the modified experimental setup used for the self-assessment, an amended computation procedure of Purkinje reflection pattern evaluation was developed. For measurement, patients and controls placed their head on a head/chin rest and fixated at 33 cm or 4 m distance in primary position. A reflex camera and three photo flash units were positioned on a special frame underneath the visual axis and in front of the subject so that both eyes could be photographed simultaneously. The camera's remote shutter control was released together with the photo flash units by the properly fixating subject. The angles of strabismus were obtained from the series of pictures through later evaluation of the Purkinje I and IV reflection patterns recorded in the photographs of the eyes. RESULTS: Measurements of the ocular alignment in two control groups and in a group of strabismic subjects showed satisfactory accuracy of the "self-assessment" method compared to "standard" Purkinje reflection pattern evaluation and orthoptic measurements of the angle of strabismus. CONCLUSION: The modified "self-assessment" method can be used for the objective recording of angles of strabismus as needed in the preoperative work-up of patients with variable angles of strabismus, over prolonged periods of time, and outside a clinical setting.

Adolescent↗

PubMed1983

Alterations in connections of the corpus callosum following convergent and divergent strabismus.

The connectivity of the corpus callosum in visual cortical areas 17 and 18 was studied in normal cats, in cats reared with unilateral convergent or divergent surgically-induced strabismus, and in a Siamese cat. The extents of the callosal cell and terminal zones were determined following multiple injections of horseradish peroxidase and tritiated amino-acids into one hemisphere. Following surgically-induced strabismus, abnormally wide callosal cell zones were seen in both the left and the right hemisphere irrespective of the direction of eye misalignment. Abnormally wide callosal terminal zones were seen in the hemisphere ipsilateral to the deviating eye in cats reared with unilateral convergent and divergent strabismus. Abnormally wide callosal zones were seen in cats which had strabismus induced as late as postnatal day 36. In a Siamese cat with a naturally-occurring convergent strabismus, callosal cells had a different distribution and were fewer in number compared to normal cats or cats with surgically induced strabismus. This implies that the abnormal callosal connectivity of Siamese cats is not a simple result of strabismus.

Animals↗

PubMed2006

Strabismus and amblyopia in bilateral Peters anomaly.

BACKGROUND: Peters anomaly is a rare form of anterior segment dysgenesis in which abnormal cleavage of the anterior chamber occurs at the end of the third week of gestation. We examined the prevalence of strabismus and amblyopia and analyzed predictive factors for their development, as well as the visual outcome and associated anomalies in patients with bilateral Peters anomaly. METHODS: Using a retrospective review, we identified 25 consecutive patients with bilateral Peters anomaly who were observed between August 1995 and February 2005. Ocular structural and systemic anomalies, amblyopia therapy, visual acuity, and binocular alignment at last visit were recorded. Fisher's exact test was used to identify any association between defined predictive factors and the development of strabismus. RESULTS: Mean follow-up time was 5.1 year (range, 0.5-21 years). Median age at presentation was 2.5 months (range, 1 day to 13 years). Penetrating keratoplasties were performed on 34 eyes in 20 patients. Final best-corrected visual acuity ranged from 20/25 to no light perception. Thirteen of 18 patients with recorded motility (72%) developed strabismus: esotropia (n = 7), exotropia (n = 5), and variable (n = 1); one also had dissociated vertical deviation. Patients with equal vision were either orthophoric (n = 4) or had intermittent esotropia (n = 1), whereas strabismus occurred in 100% of patients whose vision was asymmetric by more than 1.5 octaves. Asymmetric vision was the only statistically significant predictive factor for the development of strabismus (P = 0.002). Amblyopia treatment resulted in improved vision in 3 of 5 patients. CONCLUSION: Strabismus occurs frequently in bilateral Peters anomaly. Asymmetric vision, (because of ocular structural anomalies) postoperative complications, and amblyopia may predispose to strabismus. Despite ocular structural limitations, amblyopia therapy is recommended in the aggressive rehabilitation of these eyes.

Amblyopia↗

PubMed2006

Factors associated with childhood strabismus: findings from a population-based study.

PURPOSE: To describe strabismus prevalence and associated factors in a representative sample of 6-year-old Australian children. DESIGN: Population-based cross-sectional study. PARTICIPANTS: One thousand seven hundred thirty-nine predominantly 6-year-old children resident in Sydney examined in 2003 and 2004. METHODS: Cover testing was performed at near and distance fixation, and with spectacles if worn. Logarithm of the minimum angle of resolution visual acuity was measured in both eyes before and after pinhole correction, after correcting any cylindrical refraction >0.50 diopters and with spectacles, if worn. Cycloplegic autorefraction (cyclopentolate) and detailed dilated fundus examination were performed. Each child's medical and perinatal histories were sought in a detailed parental questionnaire. MAIN OUTCOME MEASURES: Strabismus was defined as any heterotropia at near or distance fixation, or both, on cover testing. Microstrabismus was defined as a deviation of fewer than 10 prism diopters. RESULTS: Strabismus was diagnosed in 48 children (2.8% of the population), 5 of whom had previously undergone surgical correction; 26 children (54%) had esotropia, 14 (29%) had exotropia, 7 (15%) had microstrabismus, and 1 child had VIth cranial nerve palsy. Prematurity was associated with a 5-fold increase in the risk of esotropia (odds ratio, 5.0; 95% confidence interval, 1.8-14.1). Visual impairment (with presenting correction) was significantly more common in children with (22.9%) than without (1.3%) strabismus (P<0.0001). The presence of strabismus was significantly associated with hyperopia, astigmatism, anisometropia, and amblyopia (P<0.0001). CONCLUSIONS: This report documents the prevalence of strabismus and its relation to other ocular signs and visual impairment in a representative sample of Australian school children. Presence of strabismus was significantly associated with prematurity.

Child↗

PubMed1997

Strabismus and mitochondrial defects in chronic progressive external ophthalmoplegia.

PURPOSE: To describe the results of strabismus surgery on three patients with chronic progressive external ophthalmoplegia, a group of rare disorders characterized by ptosis and slowly progressive ophthalmoparesis that has been shown to result from defects in mitochondrial DNA. METHODS: Strabismus surgery using the adjustable suture technique was performed in three patients with strabismus and chronic progressive external ophthalmoplegia confirmed by clinical, biochemical, histopathologic, and genetic criteria. All three patients had mitochondrial DNA deletions. Two patients were exotropic; one patient was esotropic. RESULTS: Rectus muscle recessions were initially unsuccessful in correcting strabismus in one patient, although a subsequent procedure employing rectus muscle resections was successful in alleviating a significant head turn and improved ocular alignment. In the two other patients, a single procedure consisting of rectus muscle recessions combined with large rectus muscle resections successfully achieved good postoperative alignment. The amount of surgery performed in these three patients exceeded that predicted in standard strabismus tables. CONCLUSIONS: The myopathic process that results in chronic progressive external ophthalmoplegia renders rectus muscle recessions less effective compared with resections for correcting the associated strabismus seen in these patients. Rectus muscle resections therefore should be an integral procedure in the surgical management of the strabismus associated with chronic progressive external ophthalmoplegia.

Adult↗

PubMed1999

The negative psychosocial impact of strabismus in adults.

INTRODUCTION: The goal in the treatment of strabismus is to realign the visual axes to eliminate diplopia, produce or restore binocular vision, expand the binocular visual field, and/or provide a normal appearance. The treatment of strabismus in adults who do not experience diplopia or who do not have binocular potential has sometimes been regarded as "cosmetic." Many adults with strabismus have stated that it has had a negative effect on their lives. This study was designed to ascertain whether there is a negative social bias against adult patients with strabismus that could affect interpersonal relationships and limit employment opportunities. METHODS: An orthotropic person was photographed in primary, right, and left gaze. These photographs were then digitally altered to produce an esotropia and exotropia of similar magnitude. Subjects were then asked to evaluate a single photograph with reference to personality characteristics that are important for social interaction and employment capability. RESULTS: Overall, the strabismic faces were judged significantly more negatively, across 11 descriptive characteristics, than the nonstrabismic face. The effect of esotropia was worse than exotropia. CONCLUSION: Strabismus creates a significant negative social prejudice. These biases can have a detrimental impact on socialization and employability. Treatment of strabismus may positively alter perceived characteristics of individuals and improve their ability to socialize normally and obtain employment. Therefore, the treatment of strabismus should not be considered cosmetic even when there is no hope of improving binocular vision.

Adolescent↗

PubMed2000

Strabismus after balanced medial plus lateral wall versus lateral wall only orbital decompression for dysthyroid orbitopathy.

PURPOSE: This study aimed to determine the relative incidence and time course of new-onset strabismus after balanced medial plus lateral wall orbital decompression versus decompression of the lateral wall alone for dysthyroid orbitopathy. METHODS: The study design was a retrospective nonrandomized comparative case series. Thirty-two consecutive patients underwent balanced medial plus lateral wall orbital decompression or lateral wall orbital decompression for dysthyroid orbitopathy. The incidence, duration, and treatment of postoperative strabismus was recorded for each patient. RESULTS: Significant preoperative strabismus was present in 31% (4/13 patients) of the balanced decompression group and in 26% (5/19 patients) of the lateral wall decompression group. Only 25% (1/4) of cases of preexisting strabismus in the balanced decompression group resolved postoperatively without muscle surgery, whereas 60% (3/5) of cases in the lateral wall decompression group resolved postoperatively without surgery. Preoperative strabismus was absent in 69% (9/13) of patients in the balanced decompression group and in 74% (14/19) of patients in the lateral wall decompression group. New-onset, persistent postoperative strabismus developed in 33% (3/9) of patients in the balanced decompression group and in 7% (1/14) of patients in the lateral wall decompression group. CONCLUSION: Lateral wall orbital decompression may produce less new-onset, persistent postoperative strabismus than balanced medial plus lateral wall orbital decompression for dysthyroid orbitopathy.

Adult↗

PubMed1996

A prospective study of the relationship between strabismus and head posture in patients with frontal plagiocephaly.

A prospective study was performed on 16 unoperated patients with frontal plagiocephaly to characterize the relationship between strabismus and abnormal head posture. Serial eye examinations were performed preoperatively and for 24 to 46 months following fronto-orbital advancement. In 14 patients (88 percent), preoperative clinical examination and CT scan indicated coronal plagiocephaly (synostotic); unicoronal synostosis was documented during fronto-orbital advancement in all these patients. Ten patients had abnormal head posture on preoperative examination, 9 of whom had strabismus at some time during the study. These 9 patients all had unicoronal synostosis with ipsilateral strabismus and a contralateral head tilt. All had eye muscle findings consistent with superior oblique paresis, although in 2 patients these signs first developed following fronto-orbital advancement. Strabismus resolved spontaneously in 2 patients between 2 and 8 months following fronto-orbital advancement; the remaining 7 patients underwent extraocular muscle surgery following fronto-orbital advancement, with early resolution of strabismus in all cases. The head tilt resolved or improved significantly in all 9 patients following resolution of the strabismus. Two patients had recurrent superior oblique paresis following surgical correction, necessitating secondary strabismus surgery. The present study indicates that extraocular muscle dysfunction is the major cause of abnormal head posture in patients with coronal plagiocephaly and emphasizes the need for long-term ophthalmologic surveillance in these patients.

Child, Preschool↗

PubMed2003

Acquired strabismus following cosmetic blepharoplasty.

The purpose of this study was to report on 12 patients with acquired strabismus following cosmetic blepharoplasty and to identify patterns of strabismus related to the surgical procedure. Clinical ophthalmologic examinations were performed to specifically clarify the type of strabismus. Operative reports of the blepharoplasty procedures were reviewed. Patients were followed for a minimum of 3 months after the blepharoplasty procedure before surgical intervention was considered. Operative findings at corrective strabismus surgery were noted and an attempt was made to correlate these findings with the clinical ophthalmologic examination and the blepharoplasty surgical procedure. Twelve cases of persistent vertical strabismus occurred following blepharoplasty procedures. Five patients had clinical findings consistent with the diagnosis of acquired superior oblique palsy; one of these five patients also showed signs of an acquired Brown syndrome. Seven patients developed an incomitant vertical deviation consistent with an inferior rectus paresis. Strabismus occurred after conventional lower lid, upper lid, and four-lid blepharoplasty with or without laser blepharoplasty. Acquired strabismus accompanied by persistent diplopia may occur as a complication of cosmetic blepharoplasty. Extraocular muscle damage resulting in either superior oblique muscle palsy or inferior rectus paresis was noted in these patients. In some cases, patients with inferior rectus paresis also showed mechanical restriction to upward rotation of the globe.

Blepharoplasty↗

PubMed2004

Early versus delayed repair of infantile strabismus in macaque monkeys: II. Effects on motion visually evoked responses.

PURPOSE: Infantile strabismus in humans and the monkey is associated with maldevelopment of visual motion responsiveness, one manifestation of which is directionally asymmetric motion visual evoked potentials (motion VEPs). Early repair of strabismus in infant monkeys has been shown to restore normal development of motion responsiveness for pursuit and optokinetic eye movements (optokinetic nystagmus [OKN]). The purpose of this study was to determine how early versus delayed repair of strabismus influences the development or maldevelopment of motion VEPs. METHODS: Optical strabismus was created in infant macaques by fitting them with prism goggles on day 1 of life. The Early Repair group wore the goggles for a period of 3 weeks (the equivalent of 3 months before surgical repair in humans), whereas the Delayed Repair group wore the goggles for a period of 3 to 6 months (the equivalent of 12-24 months before surgical repair in humans). Several months after the removal of the goggles, motion VEPs to horizontally oscillating grating stimuli were recorded during monocular viewing. An asymmetry index (AI) was measured for each animal by extracting an asymmetric (F1) and symmetric (F2) frequency component from the motion VEP. The AIs of the infant monkeys with Early versus Delayed Repair were also compared with that of a group of adult monkeys, who had unrepaired, natural strabismus. RESULTS: When tested with a 1-cyc/deg, 6-Hz stimulus, both control and Early Repair monkeys exhibited symmetric motion VEPs (AI < 0.25). Mean AI was 0.15 +/- 0.09 in control and 0.16 +/- 0.13 in Early Repair monkeys. In contrast, both Delayed Repair and naturally strabismic monkeys had asymmetric motion VEP responses: AI = 0.57 +/- 0.22 in the Delayed Repair and 0.49 +/- 0.17 in the naturally strabismic monkeys (P < 0.01). Delayed Repair and naturally strabismic monkeys also had motion VEP asymmetries of equivalent magnitude when tested using stimuli at higher (3 cyc/deg/11 Hz) spatial-temporal frequencies. The concordance between motion VEP symmetry and normal fusional vergence was significant (P < 0.01). CONCLUSIONS: Early repair of optical strabismus in primates restores normal development of visual motion pathways in the cerebral cortex, measured as symmetric motion VEPs. Delayed repair causes permanent motion VEP maldevelopment. These results provide additional evidence that early strabismus repair is beneficial for brain development in infant primates.

Animals↗

PubMed2006

The VF-14 and psychological impact of amblyopia and strabismus.

PURPOSE: To assess the impact of amblyopia, strabismus and glasses on subjective visual and psychological function among amblyopes. METHODS: Questionnaires were administered to 120 teenagers with amblyopia (cases), with residual amblyopia after treatment, or with or without strabismus and 120 control subjects (controls) Cases underwent ophthalmic examination including cycloplegic refraction. Two questionnaires (visual function 14 [VF-14] and a newly designed eight-item questionnaire) were administered to assess the psychological impact score of general daily life, having a weaker eye, glasses wear, and current noticeable strabismus. Questionnaires were validated in 60 subjects in each group by a second administration of the questionnaire. The VF-14 scores, psychological impact scores, and clinical data were compared. RESULTS: The VF-14 and psychological impact scores were highly reproducible. The mean VF-14 score for the control group was 95.5 and for the cases was 78.9 (P < 0.0001), but the scores did not correlate with the severity of amblyopia. The psychological impact score in general daily life was sensitive in discriminating between mild (median score 31) and moderate to severe (median score 56) amblyopes (P < 0.02). The cases segregated into two clear groups; those who scored high (large detrimental psychological impact) on psychological impact, with subjectively noticeable manifest strabismus, and those who scored low (low detrimental psychological impact), without noticeable strabismus. The subjective experience of patching treatment differentiated the two groups best of all. CONCLUSIONS: Subjective visual and psychological functions are altered compared with normal subjects due to amblyopia, strabismus, and a previous unpleasant patching experience. The mean VF-14 score was similar to that previously published for patients with glaucoma. The study underlines that amblyopia and/or strabismus have an impact on teenagers' subjective visual function and well-being.

Activities of Daily Living↗

PubMedDate not supplied

The role of drug treatment in children with strabismus and amblyopia.

Strabismus, or misalignment of the eyes, is a common ophthalmic problem in childhood, affecting 2 to 5% of the preschool population. Amblyopia is an important cause of visual morbidity frequently associated with strabismus, and both conditions should be treated simultaneously. Pharmacological means for treating strabismus and amblyopia can be divided into 3 categories: paralytic agents (botulinum toxin) used directly on the extraocular muscles to affect eye movements; autonomic agents (atropine, miotics) used topically to manipulate the refractive status of the eye and thereby affect alignment, focus and amblyopia; and centrally acting agents, including levodopa and citicoline, which affect the central visual system abnormalities in amblyopia. Botulinum toxin, the paralytic agent that causes the clinical symptoms of botulism poisoning, can be injected in minute quantities to achieve controlled paralysis of the extraocular muscles. Although the role of botulinum toxin is established in adults with paralytic strabismus, its usefulness in the treatment of comitant childhood strabismus (primary esotropia and exotropia) is not universally accepted. Botulinum injections tend to be more effective with smaller degrees of strabismus, in patients with good binocular fusion, and in managing overcorrections or undercorrections after traditional muscle surgery. Inadvertent ptosis and paralysis of adjacent muscles, unpredictable responses and technical constraints of the injections limit its use in children. Miotic therapy, by altering the refractive state of the treated eye, offers an alternative to optical correction with bifocals in treating esotropia due to excessive accommodative convergence. It is also effective in treating residual esotropia following surgery. The ease of use of glasses restricts the wide application of miotics in these common strabismus syndromes. Atropine, an anticholinergic agent, paralyses the ability of the eye to focus or accommodate. In amblyopia therapy, atropine is used to blur vision in the non-amblyopic eye and offers a useful alternative to traditional occlusion therapy with patching, especially in older children who are not compliant with patching. The neurotransmitter precursor levodopa and the related compound citicoline have been demonstrated to improve vision in amblyopic eyes. The therapeutic role of these centrally acting agents in the clinical management of amblyopia remains unproven.

Amblyopia↗

PubMedDate not supplied

Strabismus associated with meningomyelocele.

INTRODUCTION: Strabismus occurs frequently in patients with spina bifida or meningomyelocele. PATIENTS AND METHODS: I performed 1544 eye examinations in 298 patients with spina bifida over a period of 15 years. The patient records were retrospectively reviewed for visual acuity, binocular function, and strabismus. Select patients with A-pattern strabismus were recalled for neuroimaging. RESULTS: Visual acuity was correctable to 20/40 in 85% of the patients. One hundred and eighty-three patients (61%) had strabismus at some time over the study period. Sixty-three percent had an esodeviation; 37% an exodeviation. A-pattern strabismus was more common in patients with exotropia (39%) than in those with esotropia (27%). Defects on neuroimaging in the region of the vertical gaze pathways in the brain stem were correlated with A-pattern strabismus. CONCLUSION: With increased longevity of the patient with spina bifida, quality-of-life issues become increasingly important. Amblyopia, strabismus, and other acquired defects in the visual system related to hydrocephalus should be closely monitored and treated when indicated.

Adolescent↗

PubMedDate not supplied

Clinical characteristics of surgically treated adult strabismus.

BACKGROUND: Strabismus is present in approximately 4% of the population with most forms becoming clinically evident in infancy and childhood. Adult strabismus, including that resulting from recurrent childhood deviations, varies in etiology, presentation, symptomatology, and response to treatment. This report is intended to prospectively characterize adults who required surgical correction of their strabismic deviation. METHODS: Beginning in 1991, a prospective computerized database was collected that contained all clinical, laboratory, and surgical information on the adult ocular motility service at the Scheie Eye Institute and The Children's Hospital of Philadelphia (Philadelphia, Pa). Analysis of those patients who underwent surgical correction of their strabismus is included in this report. Demography, clinical characteristics, and surgical procedures including results were analyzed separately in adults with their strabismus beginning before visual maturation (BVM) (9 years of age) and after visual maturation (AVM). RESULTS: A minimum of 6 months and average of 1.8 years follow up is reported on 262 procedures in 255 patients with an average age of 37 between January 1991 and January 1996. Sixty-two percent of patients had their strabismus onset BVM. Fifty-one percent of BVM patients and 80% of AVM patients had incomitant deviations. Adjustable suture surgery was performed on 97% of all patients, with 28% of BVM and 57% of AVM patients having multiplanar surgery. Successful motor alignment was achieved in 85% of all patients after one surgical procedure. Sensory success was achieved in 81% of all AVM patients and 25% of all BVM patients. Subjective success was 94% in both groups of patients. CONCLUSIONS: Numerous differences exist between childhood and adult strabismus characteristics and response to surgery. Although strabismus surgery is effective, differences in results reflect the varied physiology regarding etiology, pathophysiology, and symptomology. Classification into AVM and BVM groups will provide continued clarity for future studies.

Adolescent↗

PubMedDate not supplied

Heredity versus abnormalities in pregnancy and delivery as risk factors for different types of comitant strabismus.

PURPOSE: To elucidate risk factors for different types of comitant strabismus, the incidence of heredity and abnormalities in pregnancy and delivery was compared among different types of strabismus. METHODS: Between May 1998 and January 1999, a prospective clinical study of 500 consecutive patients with comitant strabismus at a referral-based university hospital was performed using data collected from questionnaires and interviews. Inclusion criteria were infantile esotropia (168 patients), accommodative and partially accommodative esotropia (97 patients), microesotropia (15 patients), acquired esotropia (12 patients), intermittent or constant exotropia (205 patients), and congenital exotropia (3 patients). Exclusion criteria were strabismus associated with systemic and central nervous system abnormalities and organic eye diseases. RESULTS: Family history was significantly more prevalent in intermittent or constant exotropia and accommodative or partially accommodative esotropia than in infantile esotropia (P<.0001 and P=.0267, respectively, Fisher's exact test). In contrast, abnormalities in pregnancy and delivery were noted at a significantly higher rate in infantile esotropia than in accommodative or partially accommodative and in intermittent or constant exotropia (P=.003 and P=.0215, respectively). Patients with infantile esotropia were significantly younger at the survey than those with the other two types of strabismus (P=.0004 and P<.0001). No significant difference was found in the number of siblings, birthweight, maternal age at delivery, or maternal cigarette smoking or alcohol drinking among these three types of strabismus. CONCLUSION: Heredity and abnormalities in pregnancy and delivery are two major risk factors for comitant strabismus and contribute at different levels to the development of infantile esotropia, accommodative or partially accommodative esotropia, and intermittent or constant exotropia.

Child↗

PubMed1994

Strabismus management.

In this article, three topics of current interest in strabismus are covered. These include strabismus after glaucoma implant surgery, management of accommodative esotropia, and the timing of treatment for strabismic amblyopia. Glaucoma implants have improved our results with difficult glaucoma syndromes, however, a high incidence of postoperative strabismus has been associated with this procedure. The mechanism of the strabismus has not been clearly defined in previous literature, but in this article we describe three mechanisms that cause strabismus after glaucoma implant surgery and describe methods for managing this problem. The standard management of accommodative esotropia has historically resulted in a large number of undercorrections. Patients with accommodative esotropia have good fusion potential as the strabismus is acquired and binocular visual development occurred during the critical period. Recent studies indicate that we should increase our surgical numbers when managing patients with accommodative esotropia. Various treatment strategies are covered in the section on accommodative esotropia. Finally, a discussion on the management of strabismic amblyopia is presented. The importance of treating amblyopia first, then secondarily correcting the strabismus is emphasized.

Accommodation, Ocular↗

PubMed2002

A preliminary report of 40 cases of strabismus microsurgery.

OBJECTIVE: To improve the quality of strabismus surgery and to find out the role of microsurgery in the field of strabismus. METHODS: We performed separation and preservation of anterior ciliary vessels (ACV), adjustable sutures, routine rectus recession, and oblique muscle surgeries under microscope in 13 cases of comitant strabismus, 19 cases of A-V syndrome and 8 cases of paralytic strabismus. RESULTS: Surgeries were performed in a very clear field under microscope. We successfully did vascular microdissection and ACV preservation. Also with the use of microscope, various kinds of strabismus microsurgery videos were recorded. CONCLUSIONS: Microscopic technique can be used to enhance the quality and accuracy of strabismus surgery and to reduce surgical damage, postoperative inflammatory reaction and scar formation. All kinds of strabismus surgery , especially, oblique muscles and complex paralytic operations can be performed under microscope.

Adolescent↗