-
Transactions of the American... 2005To determine the utility (quality-of-life weight) associated with adult strabismus.
PURPOSE
To determine the utility (quality-of-life weight) associated with adult strabismus.
METHODS
Time tradeoff utility values were measured in physician-conducted interviews with 140 adult patients with strabismus in a private practice setting. Patients also completed a questionnaire containing six items that rated the following aspects of disability: specific health problems, problems with tasks of daily living, problems with social interaction, self-image problems, concerns about the future, and job-related problems. Patients were characterized as presurgical or nonsurgical, and their diplopia and asthenopia were rated by the physician on a four-level scale.
RESULTS
About 60% of all patients indicated willingness to trade part of their life expectancy in return for being rid of strabismus and its associated effects. The median utility was 0.93 (interquartile range, 0.83 to 1.0). A significantly smaller proportion (44%) of the nonsurgical patients (N = 41) appeared willing to trade time compared with surgical patients (68%; P = .009). Median utility in the presurgical patients was 0.90. Strong relationships were found between utility and the level of diplopia (P < .0001), and between utility and the level of asthenopia (P < .0001). Utility was correlated with all six disability ratings (all P < or = .00062).
CONCLUSION
A majority of the patients interviewed would trade a portion of their life expectancy in return for being rid of strabismus and its associated effects. These results were validated by significant associations with diplopia, asthenopia, and disability.
Topics: Activities of Daily Living; Adult; Aged; Aged, 80 and over; Anxiety; Asthenopia; Cost of Illness; Diplopia; Disability Evaluation; Employment; Female; Health Status; Humans; Interpersonal Relations; Interviews as Topic; Longevity; Male; Middle Aged; Ophthalmologic Surgical Procedures; Quality of Life; Reproducibility of Results; Self Concept; Severity of Illness Index; Strabismus; Surveys and Questionnaires
PubMed: 17057800
DOI: No ID Found -
European Journal of Vascular and... Aug 2017
Topics: Chest Pain; Computed Tomography Angiography; Device Removal; Diplopia; Equipment Design; Foreign-Body Migration; Humans; Male; Pulmonary Artery; Treatment Outcome; Vascular Surgical Procedures; Young Adult
PubMed: 28495441
DOI: 10.1016/j.ejvs.2017.04.007 -
BMC Ophthalmology Oct 2022Many researchers have noticed that there is an increasing trend of Bielschowsky acquired comitant esotropia (ACE) in recent years related to excessive near work, but the...
BACKGROUND
Many researchers have noticed that there is an increasing trend of Bielschowsky acquired comitant esotropia (ACE) in recent years related to excessive near work, but the exact pathogenesis and treatment methods have not been reported yet. Therefore, we aimed to characterize the clinical features of this ACE in adults and to evaluate the efficacy of botulinum toxin (BTX) injections in these patients.
METHODS
This was a prospective consecutive case series of 47 patients with Bielschowsky ACE. BTX was injected bilaterally into the medial rectus muscle of 45 patients, and twenty-seven of them (27/45) completed 10 months of follow-up after their last injection. Angle of deviation, fusion, stereopsis, subjective assessment of diplopia were documented before and after BTX treatment, and repeated measures data were compared by the Wilcoxon signed-rank test or Analysis of variance. The relationship between BTX dosage and corrected esotropia was explored by the Regression analysis. Meanwhile, possible risk factors for ACE including time spent on near work, refraction error, patients' personality, glasses wearing habits and duration of symptoms were recorded and analyzed with General Linear Models.
RESULTS
The patients aged 32.32 ± 10.96 (range 15-53) years spent 8.34 ± 2.38 h on near work each day, and most myope habitually removed their glasses at near. Their chief complaint was distance diplopia, with more significant esotropia at distance (around 20 PD) than at near. This series of patients also exhibited perfectionist tendencies. However, most patients achieved orthophoria after BTX treatment, only with a mild residual esotropia (+ 3.96 ± 5.79 PD), which left them asymptomatic most of the time.
CONCLUSION
This group of ACE patients was characterized by diplopia with more significant esotropia at distance. Besides excessive near-work, habitually removing myopic glasses and perfectionist tendencies may also contribute to this type of ACE. Fortunately, bilateral BTX injection safely and effectively reduced the esotropia with complete resolution of symptoms, especially for those treated at an early stage.
Topics: Adult; Botulinum Toxins; Diplopia; Esotropia; Humans; Myopia; Oculomotor Muscles; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 36195859
DOI: 10.1186/s12886-022-02612-7 -
Ophthalmic Plastic and Reconstructive...Traumatic detachment of the superior oblique muscle from the trochlea is very rare. The authors present a case of cyclovertical diplopia in downgaze due to traumatic...
Traumatic detachment of the superior oblique muscle from the trochlea is very rare. The authors present a case of cyclovertical diplopia in downgaze due to traumatic trochlear damage where they performed surgery more than 40 years later. For the first time ever, they describe the reconstruction of the trochlea using a silicone tube, thereby regaining superior oblique muscle function.
Topics: Humans; Oculomotor Muscles; Diplopia
PubMed: 37615294
DOI: 10.1097/IOP.0000000000002498 -
Clinical & Experimental Optometry Apr 2022Acute acquired comitant esotropia (AACE) is characterised by the acute onset of diplopia which affects work and life.
CLINICAL RELEVANCE
Acute acquired comitant esotropia (AACE) is characterised by the acute onset of diplopia which affects work and life.
BACKGROUND
To describe the clinical characteristics and discuss the aetiology of acute acquired comitant esotropia.
METHODS
The medical records of 51 patients with AACE were retrospectively analysed, and their age, occupation, daily average time spent on near work, angle of deviation, refractive error and aetiology were analysed.
RESULTS
The age at onset of AACE was eight to 55 years. Thirty-nine patients were aged 12 to 36 years (76.5%), and 42 patients (82.4%) were myopic. The angle of deviation was 20 (12 to 35) during near fixation and 25 (18 to 40) during distance fixation. The deviation during distance fixation was larger than that during near fixation, the difference being statistically significant (p < 0.001). The daily average time of near work before onset was 9.0 h (8.0 h to 10.0 h); 35 patients (68.6%) spent more than 8 h performing near work. Their occupations included students, accountants, information technology staff, and those who required electronic use for a long time. There is no correlation between the angle of deviation and the time of near work (p > 0.05). Among the 51 patients, three had intracranial diseases. Diplopia resolved in 47 cases following treatment. The angle of deviation post-treatment was 0 (0 to 5) during near and 0 (0 to 3) during distance fixation.
CONCLUSION
AACE occurs mostly in myopic older children and adults. The onset of esotropia is related to long-term near work. AACE patients mostly present an angle of deviation that is larger during distance than near fixation. Intracranial disease is an infrequent but important cause of AACE that needs to be excluded in all cases.
Topics: Acute Disease; Adolescent; Adult; Child; Diplopia; Esotropia; Humans; Refractive Errors; Retrospective Studies; Young Adult
PubMed: 33926368
DOI: 10.1080/08164622.2021.1914510 -
The British Journal of Ophthalmology Aug 1989Acute acquired comitant esotropia has been used to describe a dramatic onset of a relatively large angle of esotropia with diplopia and minimal refractive error. We...
Acute acquired comitant esotropia has been used to describe a dramatic onset of a relatively large angle of esotropia with diplopia and minimal refractive error. We describe six children aged 5 to 11 years who developed an acute non-accommodative esotropia with diplopia. Neurological examination, including CT scan, in each of these children gave negative results. We suggest that this is an unusual presentation of esotropia of undetermined aetiology. The diagnosis, clinical characteristics, and management are discussed.
Topics: Acute Disease; Child; Child, Preschool; Diplopia; Esotropia; Female; Humans; Male; Strabismus
PubMed: 2765443
DOI: 10.1136/bjo.73.8.636 -
Internal Medicine (Tokyo, Japan) Jul 2021Giant cell arteritis (GCA) is vasculitis of large-sized vessels that can lead to vision loss. We herein report a rare case of GCA accompanied by ptosis and diplopia as...
Giant cell arteritis (GCA) is vasculitis of large-sized vessels that can lead to vision loss. We herein report a rare case of GCA accompanied by ptosis and diplopia as early symptoms, which were caused by third nerve palsy. A 78-year-old man presented with fever, right temporal headache, right eyelid ptosis, and diplopia. GCA was confirmed by a temporal artery biopsy. The symptoms disappeared after a slight delay following the administration of prednisolone. Unlike vision loss, ptosis and diplopia are considered to be reversible and responsive to treatment. GCA should not be ruled out if patients exhibit these ophthalmic symptoms.
Topics: Aged; Biopsy; Blepharoptosis; Diplopia; Giant Cell Arteritis; Humans; Male; Prednisolone; Temporal Arteries
PubMed: 33583895
DOI: 10.2169/internalmedicine.6521-20 -
American Journal of Ophthalmology Jun 2014To report change in strabismus-specific health-related quality of life (HRQOL) following treatment with prism.
PURPOSE
To report change in strabismus-specific health-related quality of life (HRQOL) following treatment with prism.
DESIGN
Retrospective cross-sectional study.
METHODS
Thirty-four patients with diplopia (median age 63, range 14-84 years) completed the Adult Strabismus-20 questionnaire (100-0, best to worst HRQOL) and a diplopia questionnaire in a clinical practice before prism and in prism correction. Before prism, diplopia was "sometimes" or worse for reading and/or straight-ahead distance. Prism treatment success was defined as diplopia rated "never" or "rarely" on the diplopia questionnaire for reading and straight-ahead distance. Failure was defined as worsening or no change in diplopia. For both successes and failures, mean Adult Strabismus-20 scores were compared before prism and in prism correction. Each of the 4 Adult Strabismus-20 domains (self-perception, interactions, reading function, and general function) was analyzed separately.
RESULTS
Twenty-three of 34 (68%) were successes and 11 (32%) were failures. For successes, reading function improved from 57 ± 27 (SD) before prism to 69 ± 27 in-prism correction (difference 12 ± 20, 95% CI 3.2-20.8, P = .02) and general function improved from 66 ± 25 to 80 ± 18 (difference 14 ± 22, 95% CI 5.0-23.6, P = .003). Self-perception and interaction domains remained unchanged (P > .2). For failures there was no significant change in Adult Strabismus-20 score on any domain (P > .4).
CONCLUSIONS
Successful correction of diplopia with prism is associated with improvement in strabismus-specific HRQOL, specifically reading function and general function.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Diplopia; Eyeglasses; Female; Health Status; Humans; Male; Middle Aged; Quality of Life; Retrospective Studies; Strabismus; Surveys and Questionnaires; Young Adult
PubMed: 24561171
DOI: 10.1016/j.ajo.2014.02.033 -
Transactions of the American... 1984A 34-year-old Caucasian woman underwent craniofacial surgery for fronto-orbital fibrous dysplasia. She developed vertical diplopia for 10 months after surgery, which...
A 34-year-old Caucasian woman underwent craniofacial surgery for fronto-orbital fibrous dysplasia. She developed vertical diplopia for 10 months after surgery, which then disappeared for 1 month. The deviation returned with a circadian pattern, 24 hours of hypertropia and exotropia with diplopia alternating with 24 hours of straight eyes and fusion. Three months after the onset of this pattern, surgery was performed, resulting in straight eye position and fusion daily. The similarities to cyclic esotropia are discussed. The etiology of circadian strabismus remains unknown.
Topics: Adult; Diplopia; Female; Fibrous Dysplasia of Bone; Humans; Orbital Diseases; Periodicity; Postoperative Complications; Strabismus
PubMed: 6535321
DOI: No ID Found -
Journal of Clinical Neuroscience :... Jul 2021The neuro-ophthalmological complications of SARS-CoV-2 infection are emerging but the spectrum of presentations and pathophysiological mechanism underpinning the... (Review)
Review
The neuro-ophthalmological complications of SARS-CoV-2 infection are emerging but the spectrum of presentations and pathophysiological mechanism underpinning the association remains to be fully determined. We describe the case of a 44-year-old female who presented with a 12-hour history of diplopia preceded by a mild headache and found to have an isolated right abducens nerve palsy. Initial vital signs were normal but she developed a fever and nasopharyngeal swab confirmed SARS-CoV-2 infection by RT-PCR. All other investigations returned normal including blood tests, chest X-ray, MRI brain and cerebrospinal fluid analysis. She remained systemically well, and there was complete resolution of the abducens palsy and diplopia at two week follow up. In the absence of an alternative underlying cause or risk factors identified, the aetiology was presumed to be microvascular and potentially related to the viral infection. We add to the evolving literature of neuro-ophthalmological associations of SARS-CoV-2, discuss possible causal mechanisms and suggest considering asymptomatic SARS-CoV-2 infection in cases of isolated abducens palsy without clear risk factors.
Topics: Abducens Nerve Diseases; Adult; Asymptomatic Diseases; COVID-19; Diplopia; Female; Humans; Magnetic Resonance Imaging; SARS-CoV-2
PubMed: 34119296
DOI: 10.1016/j.jocn.2021.04.011