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1.
Strabismus ; 28(1): 35-41, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31868064

RESUMO

Purpose: The aim of this study is to determine the prevalence of tropia, phoria, and their types in Islamic Azad University students in Shahrekord, Iran.Methods: Of 826 students that were invited, 752 participated in this cross-sectional study (response rate = 91.04%). After applying exclusion criteria, statistical analyses were performed on the data of 726 individuals. All participants underwent optometric tests including measurement of visual acuity, objective and subjective refraction, as well as binocular vision and ocular health examinations. The unilateral and alternate cover tests were done to detect the tropia and phoria at 6 m and 40 cm, respectively.Results: The overall prevalence and 95% confidence interval (CI) of tropia, exotropia, and esotropia were 1.5% (0.8 to 2.7), 1.2% (0.6 to 2.4), and 0.3% (0.1 to 1.1), respectively. The prevalence of esotropia was significantly higher in older age groups (24 years old) (p = .040) . The prevalence of exotropia was significantly higher in females (0.039) and in myopic individuals (p = .001). The overall prevalence and 95% CI of phoria, exophoria, and esophoria were 12.9% (10.7 to 15.6), 11.7% (9.6 to 14.3), and 1.2% (0.6 to 2.3), respectively. There was a significant difference in the overall prevalence of exophoria according to the age (0.021). The prevalence of esophoria was significantly higher in females (p = .039). The prevalence of exophoria was significantly higher in myopic participants (p = .003). Exophoria and exotropia were the most common types of phoria and tropia, respectively.Conclusion: The prevalence of strabismus in university students was similar to the Iranian general population but lower than other countries. One in every 10 students had phoria, which was much lower than similar reports on Iranian populations; however, due to near-work activity, these students are prone to asthenopia, early visual fatigue, and decreased productivity. Therefore, it is suggested that university students also undergo screening programs to detect the cases of tropia and phoria.


Assuntos
Esotropia/epidemiologia , Exotropia/epidemiologia , Estrabismo/epidemiologia , Estudantes/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Esotropia/diagnóstico , Exotropia/diagnóstico , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Procedimentos Cirúrgicos Oftalmológicos , Prevalência , Estrabismo/diagnóstico , Testes Visuais , Visão Binocular/fisiologia , Acuidade Visual/fisiologia , Adulto Jovem
2.
Strabismus ; 27(4): 199-204, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31637944

RESUMO

Cerebral palsy, neurological abnormalities, prematurity or periventricular lesions may affect motor and sensory fusion mechanisms that favorably control eye alignment. White matter damage of immaturity (WMDI) is a form of white matter brain injury characterized by the necrosis of white matter near the lateral ventricles. In these cases, it is difficult to establish fusion after strabismus surgery and consecutive deviations may be seen more frequently especially in association with WMDI. The aim of this study is to evaluate and compare the cerebral magnetic resonance imaging (MRI) findings in operated infantile esotropia cases with and without consecutive exotropia and to relate them to the occurance of consecutive exotropia.Seventeen patients that had consecutive exotropia after bilateral medial rectus recession surgery for infantile esotropia were included in this study (group 1) and patients that were operated with the same diagnosis with a successful surgical outcome (≤10 PD of deviation) were recruited as group 2. Age, sex, consanguinity, associated systemic and neurological diseases, prematurity, visual acuity, angle of deviations at first visit, at last and follow-up visit and after surgery, cycloplegic retinoscopy, fundus and cerebral MRI findings were recorded. Demographic and clinical findings of patients in two groups and MRI findings were evaluated and compared.The mean age at the time of first examination was 8.21 ± 6.62 and 7.45 ± 4.94 months in infantile esotropia patients with (group 1) and without consecutive exotropia (group 2), respectively. The mean cycloplegic refractive errors (+1.92 ± 1.57 D vs. +2.30 ± 1.10 D), the mean preoperative angle of deviation (46.33 ± 18.8 PD vs. 34.8 ± 12.5 PD), sex, percentage of consanguinity, percentage of prematurity, presence of latent nystagmus, dissociated vertical deviation and amblyopia and fundus findings were similar in both groups. Patients with consecutive exotropia had a mean deviation angle of 37.5 ± 9.48 PD postoperatively. Cerebral MRI findings were consistent with WMDI (three patients), myelinization delay (one patient), septooptic dysplasia (one patient) and periventricular cysts (one patient) in group 1. Cerebellar hemispheres and vermis hypoplasia (one patient), myelinization delay (one patient), cerebellar atrophy (one patient) were the MRI findings of patients in group 2.White matter damage of immaturity was only present in the consecutive exotropia group. This finding may suggest that WMDI can be a risk factor for consecutive deviation in infantile esotropia patients.


Assuntos
Esotropia/diagnóstico , Exotropia/diagnóstico , Leucoencefalopatias/diagnóstico , Imagem por Ressonância Magnética , Substância Branca/diagnóstico por imagem , Pré-Escolar , Esotropia/cirurgia , Feminino , Seguimentos , Humanos , Lactente , Masculino , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Estudos Retrospectivos
3.
BMC Ophthalmol ; 19(1): 173, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391009

RESUMO

BACKGROUND: To describe the clinical characteristics and the outcomes of strabismus surgery for acute acquired comitant esotropia (AACE). METHODS: Medical records of 45 AACE patients were retrospectively analyzed. The insertion location of medial rectus was compared between the AACE patients and comitant exotropic patients. The location was also compared with those measured in other studies. Surgical outcome measurements included amount of deviation and level of binocularity at last follow-up. RESULTS: The distance from medial rectus to limbus was shorter in AACE patients than in patients with comitant exotropia. The distance was also shorter in AACE patients than patients in other studies. Out of the 45 patients, 2 had neurological diseases. Neostigmine test was negative in all patients. The age at onset of AACE was 5-47 years (mean 19.1 ± 7.3 years), one patient was 5 years (2.2%), 20 patients were 11-17 years (44.5%) and the other 24 patients were 18-47 years old (53.3%). The mean cycloplegic refraction was - 4.1 ± 3.0 diopters (D) and 41 patients were myopic (91%). The angle of deviation was 40.5 ± 19.5 prism diopters (PD) at distance and 35.6 ± 19.9PD at near preoperatively. The angle was 0.8 ± 1.6 PD at distance and 0.7 ± 1.8 PD at near postoperatively. Diplopia resolved in patients who underwent strabismus surgery, with no recurrence during the follow-up period. Thirty patients had stereopsis postoperatively. CONCLUSIONS: AACE seems to occur mostly in older children and adults and myopes. The distance from the insertion to limbus of medial rectus was shorter in patients with AACE. Good results can be achieved by strabismus surgery.


Assuntos
Percepção de Profundidade/fisiologia , Esotropia/cirurgia , Movimentos Oculares/fisiologia , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Acuidade Visual , Doença Aguda , Adolescente , Adulto , Criança , Esotropia/diagnóstico , Esotropia/fisiopatologia , Feminino , Seguimentos , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/fisiopatologia , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
4.
BMC Ophthalmol ; 19(1): 185, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31420011

RESUMO

BACKGROUND: Horizontal eye movements have been proposed to induce biomechanical stress and strain on optic nerve head. Since strabismus may lead to sustained adduction or abduction, we investigate the effects of long lasting unilateral horizontal strabismus on the morphology of optic disc. METHODS: The observational cross-sectional study included patients with unilateral constant horizontal strabismus lasting for more than two years. The patients underwent an ophthalmological examination including refraction and morphometry of the optic nerve head. A prism cover test using right angle glass prism was performed to measure the magnitude of the ocular deviation. RESULTS: The study included 70 patients with a unilateral constant strabismus (35 esotropic patients, 35 exotropic patients) with a mean age of 26 ± 19 years, mean refractive error of - 0.72 ± 3.3 diopters, mean axial length of 23.8 ± 1.7 mm, and a mean angle of deviation of 87 ± 36 prism diopters (Chinese right-angle glass method) in the esotropic group and - 97 ± 29 prism diopters in the exotropic group. In the whole study population and taken separately in the esotropic group and exotropic group, the disc ovality index (defined as ratio of minimal-to-maximal optic disc diameter) did not differ significantly between the deviating eyes and the contralateral fixating eyes (all P > 0.05). As a corollary, the disc ovality index and the prevalence of parapapillary beta/gamma zone did not differ significantly between the esotropic group and the exotropic group (all P > 0.05). CONCLUSIONS: Optic disc ovality did not differ markedly among long-lasting esotropic eyes, exotropic eyes, and non-strabismic eyes. It suggests that optic disc shape may not be markedly influenced in non-highly myopic eyes by a potential backward pull of the optic nerve on the optic disc structures in adduction or abduction.


Assuntos
Esotropia/diagnóstico , Exotropia/diagnóstico , Oftalmoscopia/métodos , Disco Óptico/diagnóstico por imagem , Acuidade Visual , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
6.
J Pediatr Ophthalmol Strabismus ; 56(3): 178-182, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31116866

RESUMO

PURPOSE: To report a series of patients with cyclic esotropia, their surgical outcomes, and incidental findings. METHODS: The medical records of five patients with cyclic esotropia presenting over 17 months were reviewed. Age at onset, ocular and motility examinations, brain magnetic resonance imaging (MRI), acetylcholine receptor antibodies, thyroid hormone levels and antibodies, calendars documenting phases, surgical treatments, postoperative alignment, and fusion were documented. RESULTS: Three boys and two girls presented at 3 to 4 years old in 2015-2016. Typical periodicity followed a 48-hour cycle. Duration of cycling varied from 1 to 9 weeks. Mean maximum deviation was 37 prism diopters (PD) of esotropia (range: 35 to 40 PD of esotropia). All patients had normal laboratory studies. MRIs showed an abnormal white matter signal in the frontal lobes in 2 patients and were normal in the others. Bilateral medial rectus recessions for the maximum angle were successful in 4 patients at a minimum follow-up of 13 months; the other patient required reoperation for a residual esotropia. Fusion was present in 4 patients preoperatively and all postoperatively. Stereopsis was stable or improved in all postoperatively. CONCLUSIONS: This is the first report of frontal white matter changes occurring in the setting of cyclic esotropia. MRI with attention to frontal lobe white matter might be considered in the work-up of cyclic esotropia to determine if this is a common finding. Bilateral medial rectus recessions can restore fusion in these patients. [J Pediatr Ophthalmol Strabismus. 2019;56(3):178-182.].


Assuntos
Esotropia/diagnóstico , Lobo Frontal/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Visão Binocular/fisiologia , Substância Branca/diagnóstico por imagem , Pré-Escolar , Esotropia/fisiopatologia , Esotropia/cirurgia , Movimentos Oculares/fisiologia , Feminino , Seguimentos , Humanos , Masculino , Músculos Oculomotores/fisiopatologia , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
7.
J Binocul Vis Ocul Motil ; 69(1): 24-25, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30806582

RESUMO

Children presenting in later childhood with isolated, acquired, comitant non-accommodative esotropia (ANAET) form an unusual clinical group whose evaluation, treatment, and prognosis are unclear. We identified 9 such patients with no evidence of intracranial pathology whose outcomes following standard bilateral medial rectus recessions were excellent.


Assuntos
Esotropia/diagnóstico , Esotropia/cirurgia , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Acomodação Ocular , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Prognóstico , Estudos Retrospectivos
8.
J Binocul Vis Ocul Motil ; 69(1): 1-2, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30615575

RESUMO

Gradenigo syndrome is a rare complication of acute otitis media infections, and early diagnosis and treatment of the condition are imperative. In this report, we present a case of a 22-month-old girl who developed acute, acquired esotropia associated with recurrent episodes of otitis media, which resolved after antibiotic treatment. To our knowledge, our patient is one of the youngest children reported in the literature to present with presumed Gradenigo syndrome and the only case of recurrent episodes of acquired esotropia and concurrent otitis media within the short time span of 1 month. We hope to add new information to the existing literature and to aid in the understanding of the pathophysiology and management of this condition.


Assuntos
Esotropia/complicações , Otite Média/complicações , Petrosite/etiologia , Doença Aguda , Antibacterianos/uso terapêutico , Esotropia/diagnóstico , Esotropia/tratamento farmacológico , Feminino , Humanos , Lactente , Otite Média/diagnóstico , Otite Média/tratamento farmacológico
9.
Graefes Arch Clin Exp Ophthalmol ; 257(3): 657-662, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30671656

RESUMO

PURPOSE: This study aimed to investigate the characteristics of the extraocular muscles and the orbital connective tissue pulleys in Japanese patients with age-related distance esotropia (ARDE) and high myopia using magnetic resonance imaging (MRI). METHODS: This was a retrospective case-series study. High-resolution coronal MRI scans of 12 orbits were obtained in 6 patients with ARDE and high myopia (age range: 51-69 years). We analyzed the images to determine the positions of the rectus muscle pulleys relative to the center of the globe, the integrity of the lateral rectus-superior rectus muscle (LR-SR) band, and the LR angle (the angle between the major axis of the LR and the vertical plane). RESULTS: The distance esotropia ranged from 4 to 25∆, and 3 cases exhibited vertical deviations. The mean (±standard deviation (SD)) axial length was 28.5 (± 1.6) mm. The mean positions of the medial rectus muscle pulley and LR pulley were 1.3 mm inferior and 1.4 mm inferior, respectively, to those seen in the normal control group in our previous study (P = 0.002 and P = 0.05, respectively). All 12 orbits had abnormal elongated LR-SR bands, and 8 orbits (67%) displayed ruptured LR-SR bands. The LR angle (mean±SD; 18.8° ± 8.5°) increased significantly with the inferior displacement of the LR pulley (R2 = 0.77, P = 0.0002). CONCLUSIONS: Inferior displacement of the LR pulley and abnormal LR-SR bands were seen in Japanese ARDE patients with high myopia, as was found in ARDE patients without high myopia. The LR angle might be useful for judging the degree of LR pulley displacement.


Assuntos
Esotropia/diagnóstico , Movimentos Oculares/fisiologia , Imagem por Ressonância Magnética/métodos , Miopia/complicações , Músculos Oculomotores/patologia , Órbita/diagnóstico por imagem , Refração Ocular/fisiologia , Fatores Etários , Idoso , Esotropia/complicações , Esotropia/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Miopia/diagnóstico , Miopia/fisiopatologia , Músculos Oculomotores/fisiopatologia , Reprodutibilidade dos Testes , Estudos Retrospectivos
10.
Indian J Ophthalmol ; 67(2): 280-282, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30672495

RESUMO

Cyclic esotropia, a rare condition of obscure etiology characterized by regularly alternating periods of esotropia and orthophoria. We present a case of a 7-year-old boy who underwent surgical correction for intermittent exotropia elsewhere and developed esotropia with cyclic pattern post-operatively. Initially the cycle was of half-day orthophoria and half-day esotropia, which later became one full day of esotropia and one day of orthophoria. During re-surgery, right lateral rectus was found to have a stretched scar which was resected and then advanced and medial rectus was recessed. Post-surgery the child was orthophoric without cyclic pattern.


Assuntos
Esotropia/diagnóstico , Movimentos Oculares/fisiologia , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Visão Binocular/fisiologia , Acuidade Visual , Criança , Doença Crônica , Esotropia/fisiopatologia , Esotropia/cirurgia , Humanos , Masculino , Músculos Oculomotores/fisiopatologia , Doenças Raras
11.
Graefes Arch Clin Exp Ophthalmol ; 257(3): 645-650, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30661115

RESUMO

PURPOSE: To validate the effectiveness of the selective wavelength filter analysis with infrared photographs for diagnosing small-angle esotropia in children under age 4. METHODS: This is a retrospective, observational, case-control study. A total of 83 esotropes with an esodeviation of ≤ 16 prism diopters (PD) and 75 orthotropic controls under 4 years of age were included. Full-face infrared photographs were taken with a selective wavelength filter in front of either eye. The angles of esodeviation on photographs were measured with the three-dimensional Strabismus Photo Analyzer. The alternate prism and cover test or the Krimsky test were repeatedly performed to measure ocular alignment. RESULTS: The testability of infrared photographs using selective wavelength filters in children under 4 years of age was 85.6%. The mean angle of esodeviation was 11.3 ± 4.0 PD by manual measurements and 11.5 ± 4.4 PD by the infrared photograph analysis. Manual measurements and the infrared photograph analysis showed a strong positive correlation (R = 0.815, P < 0.001). The sensitivity and specificity of the infrared photograph analysis for detecting small-angle esotropia were 95.2% and 77.9%, respectively, with a cutoff value of 4.0 PD. CONCLUSIONS: The automated infrared photograph analysis was simple and effective for diagnosing small-angle esotropia in young children.


Assuntos
Técnicas de Diagnóstico Oftalmológico , Esotropia/diagnóstico , Raios Infravermelhos , Músculos Oculomotores/diagnóstico por imagem , Fotografação/métodos , Visão Binocular , Estudos de Casos e Controles , Pré-Escolar , Esotropia/fisiopatologia , Feminino , Humanos , Lactente , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos
12.
PLoS One ; 14(1): e0203584, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30682011

RESUMO

PURPOSE: To compare the changes of spherical equivalent refractive error (SER) and axial length (AL) for three years in hyperopic children with minimal undercorrection according to the presence of accommodative esotropia (AE). METHODS: A total of 67 hyperopic children were enrolled. The patients were divided into 3 groups and matched by initial age upon examination; esotropic eyes with AE (AE group), fellow eyes with AE (FE group), and right eyes without esotropia (HE group). Changes of SER and AL were serially measured every six months for three years and collected data were compared among the groups. RESULTS: All three groups underwent significant myopic shift and AL elongation during the follow-up period. However, the least amount of change was found in the AE group. The AE group (-0.96 ± 1.38D) exhibited significantly less change in SER compared to the HE group (-1.76 ± 1.11D) and the FE group (-1.57 ± 1.33D) (both p<0.001). Meanwhile, smaller changes of AL were noticeable in the AE group (0.62 ± 0.88mm) compared to the other two groups (HE 0.99 ± 0.29mm; p<0.001, FE 0.73 ± 0.65mm; p = 0.04). The SER and AL changes were not significantly different between the HE group and FE group. CONCLUSIONS: Esotropic eyes with AE patients with minimal undercorrection exhibited little negative shift of SER and AL elongation compared to not only hyperopic eyes without AE but also fellow eyes with AE.


Assuntos
Acomodação Ocular/fisiologia , Comprimento Axial do Olho/crescimento & desenvolvimento , Esotropia/fisiopatologia , Hiperopia/fisiopatologia , Comprimento Axial do Olho/fisiopatologia , Criança , Desenvolvimento Infantil/fisiologia , Pré-Escolar , Esotropia/diagnóstico , Esotropia/terapia , Óculos , Feminino , Seguimentos , Humanos , Hiperopia/diagnóstico , Hiperopia/terapia , Masculino , Refração Ocular , Estudos Retrospectivos , Índice de Gravidade de Doença
13.
Surv Ophthalmol ; 64(6): 884-890, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30385270

RESUMO

A 74-year-old woman experienced chronic painless progressive binocular horizontal diplopia for 2 years. Initial examination showed a visual acuity of 20/20 OU. External and slit lamp examination was unremarkable. Orthoptic evaluation showed an incomitant esotropia, a small vertical strabismus, and a large degree of excyclotorsion. Investigation revealed a diagnosis of diffuse large B-cell lymphoma.


Assuntos
Neoplasias Oculares/diagnóstico , Linfoma Difuso de Grandes Células B/diagnóstico , Idoso , Diplopia/diagnóstico , Esotropia/diagnóstico , Feminino , Humanos , Estrabismo/diagnóstico
14.
J Fr Ophtalmol ; 42(1): 16-21, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30559014

RESUMO

PURPOSE: To evaluate the interobserver reproducibility of objective ocular torsion measurements in infantile esotropia using fundus photography analysis. MATERIALS AND METHODS: This retrospective observational study was conducted in our ophthalmology department at the University Hospital in Tours from 2009 to 2015. OBJECTIVE: Ocular torsion was assessed using fundus photography and analysed on Adobe Photoshop software within a population of children with infantile esotropia. Two observers, an orthoptist and an ophthalmologist, carried out the evaluation separately. The interobserver agreement was calculated for quantitative measurement by the interclass correlation coefficient (ICC) and by Cohen's Kappa coefficient for qualitative assessment. RESULTS: A total of 200 eyes (100 subjects, mean age: 6.88 years) were assessed. Statistical analyses for quantitative measurements resulted in an ICC of 0.98 (95% CI, 0.97-0.99) for right eyes, 0.96 (95% CI, 0.95-0.97) for left eyes, 0.98 (CI 95%, 0.97-0.98) for pre- operative eyes and 0.96 (95% CI, 0.95-0.97) for postoperative eyes. The ICC calculated on all four hundred fundus photographs was 0.97 (95% CI, 0.97-0.98). The interobserver agreement for qualitative measurements resulted in a Kappa coefficient of 0.91 for right eyes, 0.85 for left eyes, 0.90 for preoperative eyes and 0.86 for postoperative eyes. The analysis of all four hundred eyes returned a Kappa coefficient of 0.88. CONCLUSIONS: Objective ocular torsion assessment using our procedure, whether by an orthoptist or ophthalmologist, is a reliable and reproducible method for the management of infantile esotropia.


Assuntos
Técnicas de Diagnóstico Oftalmológico , Esotropia/congênito , Esotropia/diagnóstico , Oftalmopatias/diagnóstico , Fotografação , Anormalidade Torcional/diagnóstico , Adolescente , Idade de Início , Criança , Pré-Escolar , Esotropia/epidemiologia , Esotropia/etiologia , Oftalmopatias/complicações , Oftalmopatias/congênito , Feminino , Fundo de Olho , Humanos , Masculino , Variações Dependentes do Observador , Músculos Oculomotores/anormalidades , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/patologia , Fotografação/métodos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Estrabismo/diagnóstico , Estrabismo/epidemiologia , Estrabismo/etiologia , Anormalidade Torcional/complicações
15.
Acta Clin Croat ; 58(3): 473-480, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31969760

RESUMO

The aim of this retrospective study was to determine the strabismus angle variability and rationality of surgical treatment of strabismus in prematurely born children with neurological impairment during 12-year follow up. Eleven premature infants born in 2003 were included in the study and treated with equal conservative approach from 2005 until 2016. Initial esotropia was found in seven and exotropia in four of eleven children. Changes in the strabismus angle correlated significantly with aging of the children. In children with initial esotropia, the strabismus angle became less convergent (less positive), changed the orientation and became more divergent with aging. In those with initial exotropia, the angle became less divergent (more positive), changed the orientation and became more convergent. Moreover, a significant difference in the strabismus angle was found during the 12-year follow up. Based on our results, due to the variability in strabismus angle, we did not find enough evidence for optimal timing or rationality of strabismus surgery in neurologically impaired children born prematurely.


Assuntos
Esotropia/diagnóstico , Esotropia/fisiopatologia , Exotropia/diagnóstico , Exotropia/fisiopatologia , Doenças do Prematuro/fisiopatologia , Adolescente , Fatores Etários , Criança , Croácia/epidemiologia , Esotropia/epidemiologia , Exotropia/epidemiologia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Doenças do Prematuro/epidemiologia , Masculino , Estudos Retrospectivos
16.
J Pediatr Ophthalmol Strabismus ; 55: e42-e44, 2018 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-30571837

RESUMO

Acute acquired comitant esotropia secondary to smart-phone use is a newly described phenomenon. This case report describes a boy with acute acquired comitant esotropia due to prolonged smartphone use who had improvement in binocular function after cessation of near work for several weeks. [J Pediatr Ophthalmol Strabismus. 2018;55:e42-e44.].


Assuntos
Esotropia/etiologia , Smartphone , Doença Aguda , Adolescente , Esotropia/diagnóstico , Esotropia/fisiopatologia , Humanos , Masculino , Visão Binocular/fisiologia
17.
J Pediatr Ophthalmol Strabismus ; 55: e36-e38, 2018 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-30388280

RESUMO

A 2-year-old boy with Alagille syndrome who had esotropia underwent bilateral medial rectus recession. One month postoperatively, esotropia reoccurred and was aggravated thereafter. Right lateral rectus resection was unsuccessful because the insertion site could not be identified. Careful preoperative imaging may be necessary in patients with Alagille syndrome to detect any abnormal extraocular muscle insertion. [J Pediatr Ophthalmol. 2018;55:e36-e38.].


Assuntos
Síndrome de Alagille/complicações , Esotropia/etiologia , Músculos Oculomotores/diagnóstico por imagem , Procedimentos Cirúrgicos Oftalmológicos/métodos , Visão Binocular/fisiologia , Pré-Escolar , Esotropia/diagnóstico , Esotropia/cirurgia , Humanos , Imagem por Ressonância Magnética , Masculino , Músculos Oculomotores/fisiopatologia , Músculos Oculomotores/cirurgia , Período Pós-Operatório
18.
J Binocul Vis Ocul Motil ; 68(4): 148-153, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30358489

RESUMO

BACKGROUND AND PURPOSE: To describe the development and treatment of patients with cyclic esotropia. PATIENTS AND METHODS: The clinical course of seven patients with cyclic esotropia were retrospectively reviewed and described. All patients underwent bilateral medial rectus recession based on the deviation manifested on the day they were esotropic. Additionally, one patient had previously undergone surgery for intermittent exotropia. RESULTS: All patients developed excellent postoperative alignment. After strabismus surgery, normal eye alignment with some degree of binocularity was reached in five patients. Moreover, there was no recurrence of the cyclic deviation in any patient, and no patient experienced an overcorrection. CONCLUSIONS: Strabismus surgery aimed to correct the horizontal esotropic angle present on the day the esotropia is manifested provides a good outcome that is stable long-term, with minimal risk of overcorrection. Possible explanations for the origin of cyclic esotropia are discussed.


Assuntos
Esotropia/diagnóstico , Esotropia/cirurgia , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Periodicidade , Criança , Pré-Escolar , Esotropia/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Visão Binocular/fisiologia
19.
J Binocul Vis Ocul Motil ; 68(2): 54-58, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30196757

RESUMO

INTRODUCTION AND PURPOSE: To investigate the role that dynamic retinoscopy can play in reducing the occurrence of infantile accommodative esotropia and facilitating emmetropization in infants with high hyperopia. PATIENTS AND METHODS: 211 orthotropic infants under 1 year of age (3.5 to 12 months) identified as having ≥5 diopters of hyperopia in their more hyperopic eye on a routine eye exam. On enrollment, infants underwent an assessment of accommodation using dynamic retinoscopy as well as a cycloplegic refraction. Infants who showed normal accommodation were followed without spectacles. If dynamic retinoscopy showed subnormal accommodation, partial hyperopic correction that allowed for full binocular accommodative responses at near were prescribed. Main outcome measures were the occurrence of esotropia, changes in refractive error, and visual acuity. RESULTS: Of the 211 infants enrolled, 146 showed normal accommodation and were followed without glasses (Group 1). None of these patients developed strabismus. Sixty-five patients showed subnormal accommodation and received partial hyperopic correction (Group 2). Thirty-four of the 65 (52%) in Group 2 did not develop strabismus (Group 2A) and 31 of the 65 (48%) developed strabismus (Group 2B). All 3 groups showed a reduction of hyperopia of 0.37D ± 0.25/year, 0.50D ± 0.28/year, and 0.60D ± 0.20/year in groups 1, 2A, and 2B, respectively. None of the differences between groups were statistically significant. CONCLUSIONS: Normal accommodation on dynamic retinoscopy in orthotropic hyperopic infants is a predictor of continued good alignment and such infants can be followed without spectacles. Partial spectacle correction based on dynamic retinoscopy may have a beneficial effect on reducing the development of strabismus without impeding emmetropization. Early binocular accommodative behavior seems to be predictive of infants at risk of developing strabismus.


Assuntos
Acomodação Ocular/fisiologia , Emetropia/fisiologia , Esotropia/diagnóstico , Retinoscopia/métodos , Pré-Escolar , Esotropia/fisiopatologia , Oftalmopatias Hereditárias/fisiopatologia , Feminino , Seguimentos , Humanos , Hiperopia/fisiopatologia , Lactente , Masculino , Refração Ocular/fisiologia , Visão Binocular/fisiologia , Acuidade Visual/fisiologia
20.
J Binocul Vis Ocul Motil ; 68(3): 78-86, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30196785

RESUMO

BACKGROUND AND PURPOSE: Spasm of the near reflex (SNR) can be a variable, unpredictable condition. There is no standard management strategy. The purpose of this paper is to summarize the pertinent information from a literature review to better identify, explain, and manage this condition. PATIENTS AND METHOD: Case presentations and retrospective literature review Results: The presumed cause of SNR can be grouped into four categories: psychogenic, head trauma, organic/neurologic, and other causes. Etiology is often presumed rather than confirmed and may be multifactorial. A number of treatments have been reported, all with unpredictable efficacy.Etiology may be the most important factor in predicting treatment outcomes. In general, SNR due to psychogenic causes often has a good prognosis but time required for resolution varies widely. SNR due to an organic/neurologic cause may resolve with treatment of the underlying condition, but a psychogenic component may also occur in these cases. SNR due to head trauma has the poorest prognosis with incomplete resolution for many. CONCLUSION: SNR is highly variable in presentation and may have various causes. Response to treatment is unpredictable but may be dependent on etiology. A standardized treatment protocol for SNR may not be attainable, but it is possible to approach management of SNR in a methodical manner. A proposed management strategy is presented.


Assuntos
Acomodação Ocular/fisiologia , Convergência Ocular/fisiologia , Transtornos da Motilidade Ocular/fisiopatologia , Transtornos da Motilidade Ocular/terapia , Reflexo Pupilar/fisiologia , Espasmo/fisiopatologia , Espasmo/terapia , Adulto , Diplopia/diagnóstico , Diplopia/fisiopatologia , Esotropia/diagnóstico , Esotropia/fisiopatologia , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Acuidade Visual/fisiologia
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