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Ugeskrift For Laeger Jan 2023Strabismus is a common condition affecting both children and adults. Strabismus patients may experience double vision, abnormal head position and loss of stereovision....
Strabismus is a common condition affecting both children and adults. Strabismus patients may experience double vision, abnormal head position and loss of stereovision. The psychosocial negative impact of strabismus may be severe, affect self-esteem, social relationships, and job opportunities. Strabismus is a congenital condition or a result of an illness in later life and surgical treatment should be considered as reconstructive surgery and not downrated as just »a cosmetic procedure«. Strabismus surgery is safe, effective and addresses functional as well as psychosocial problems.
Topics: Adult; Child; Humans; Strabismus; Oculomotor Muscles; Plastic Surgery Procedures; Interpersonal Relations
PubMed: 36760141
DOI: No ID Found -
Romanian Journal of Ophthalmology 2016Age related binocular vision disorders (age related strabismus) could include all types of spontaneous strabismus appearing along the lifetime, which are directly... (Review)
Review
Age related binocular vision disorders (age related strabismus) could include all types of spontaneous strabismus appearing along the lifetime, which are directly connected with the aging process. Neurological strabismus is excluded. Functional and structural changes related to the aging process can induce phoria decompensation, convergence insufficiency decompensation and new onset strabismus as distance esotropia or vertical strabismus induced by the sagging eye syndrome. MRI studies sustain the hypothesis of age related structural changes of extraocular muscles pulleys and their influence on the eye position and motility nominated as sagging eye. Age Related Distance Esotropia, Age Related Divergence Insufficiency Esotropia are probably different names for the same type of strabismus. All types of age related binocular disorders require treatment because of the accompanying diplopia. Prisms or/ and surgery can improve the patients' life quality by eliminating diplopia in primary position and main gazes.
Topics: Aging; Humans; Magnetic Resonance Imaging; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Strabismus; Vision Disorders; Vision, Binocular
PubMed: 29450323
DOI: No ID Found -
Eye (London, England) Feb 2015Binocular stereopsis, or stereo vision, is the ability to derive information about how far away objects are, based solely on the relative positions of the object in the... (Review)
Review
Binocular stereopsis, or stereo vision, is the ability to derive information about how far away objects are, based solely on the relative positions of the object in the two eyes. It depends on both sensory and motor abilities. In this review, I briefly outline some of the neuronal mechanisms supporting stereo vision, and discuss how these are disrupted in strabismus. I explain, in some detail, current methods of assessing stereo vision and their pros and cons. Finally, I review the evidence supporting the clinical importance of such measurements.
Topics: Depth Perception; Humans; Strabismus; Vision, Binocular
PubMed: 25475234
DOI: 10.1038/eye.2014.279 -
The Turkish Journal of Pediatrics 2022Pediatricians are regularly involved in the initial examination of children presenting with strabismus, a common ocular condition occurring in 3% of children. The... (Review)
Review
BACKGROUND
Pediatricians are regularly involved in the initial examination of children presenting with strabismus, a common ocular condition occurring in 3% of children. The objective of this review was to gain insight into pediatric residents, fellows and attendings` understanding of strabismus, and to propose an etiology-based strabismus classification scheme to aid this understanding.
METHODS
A survey was conducted in a single Department of Pediatrics in a university academic institution in order to assess the degree of understanding of the classification, etiology and nomenclature of strabismus. A targeted literature review, pertinent to our classification scheme for strabismus in the pediatric age group, is provided to clarify the various underlying etiological conditions for pediatricians.
RESULTS
The surveyed cohort (n=26) consisted of 10 (38.5%) attendings and 16 (61.5%) pediatricians-in-training. Although 69% of survey participants felt comfortable performing an ocular motility evaluation, only 19% had a clear understanding of the underlying etiology of strabismus, 8% had a clear understanding of strabismus nomenclature and none of the participants had clear knowledge of a classification scheme of strabismus. We propose an etiologic-based strabismus classification scheme with streamlined nomenclature geared towards Pediatricians to facilitate the management of pediatric patients with various ocular misalignments. Eight major categories of this classification scheme include (1) physiologic, (2) comitant, (3) paralytic, (4) sensory, (5) syndromic, (6) orbital, (7) supranuclear and (8) pseudostrabismus.
CONCLUSIONS
Pediatricians at all levels of professional experience have a limited command of strabismus. An etiology-based classification scheme of strabismus may assist in understanding the underlying causes and facilitate the management of strabismus in the pediatrician`s office.
Topics: Child; Cohort Studies; Humans; Pediatricians; Strabismus; Surveys and Questionnaires
PubMed: 35611422
DOI: 10.24953/turkjped.2020.2372 -
Indian Journal of Ophthalmology Oct 2022To study the presence and development of strabismus in children with telecanthus, epicanthus, and hypertelorism. (Observational Study)
Observational Study
PURPOSE
To study the presence and development of strabismus in children with telecanthus, epicanthus, and hypertelorism.
METHODS
This is a prospective, longitudinal, and observational study. Sixty children aged between 6 months and 18 years with telecanthus, epicanthus, and hypertelorism in isolation or in combination were recruited. A detailed analysis of the history, determination of best corrected visual acuity, complete evaluation of strabismus, and ocular examination were carried out. The presence of telecanthus, epicanthus, and hypertelorism and associated strabismus, if any, was noted. All children were followed up for a minimum and maximum period of 12 and 18 months, respectively, to analyze the strabismus (previously present) and for detection of strabismus in those who did not have. The data were analyzed descriptively with mean and standard deviation. Chi square test and Fishers exact test were used to analyze the data between the groups. A P value less than 0.05 was considered to be statistically significant.
RESULTS
Telecanthus was the most common lid feature (55%). At baseline, ten (16.66%) children had strabismus (six: esotropia; four: exotropia). Two (3.33%) children underwent surgery. One child developed exotropia at the third follow-up (18 months). At the end of the study, 11 (18.33%) children had strabismus. No significant association was seen between lid characteristics and the type of strabismus.
CONCLUSION
Children with telecanthus, epicanthus, and hypertelorism in isolation or in combination may or may not have associated strabismus. These features can pose difficulty in strabismus diagnosis, which mandates a careful examination, especially in younger age groups and small-angle strabismus. On the other hand, children without strabismus need longer follow-up to detect the development of strabismus and to initiate further management at the earliest.
Topics: Child; Craniofacial Abnormalities; Esotropia; Exotropia; Eyelids; Humans; Hypertelorism; Infant; Prospective Studies; Retrospective Studies; Strabismus; Visual Acuity
PubMed: 36190058
DOI: 10.4103/ijo.IJO_776_22 -
Australian Family Physician Dec 2013Strabismus ('squint') is a common childhood disorder that can cause psychosocial distress and permanent functional disability. Early diagnosis is important to maximise... (Review)
Review
BACKGROUND
Strabismus ('squint') is a common childhood disorder that can cause psychosocial distress and permanent functional disability. Early diagnosis is important to maximise visual rehabilitation and reduce the risk of amblyopia. There is currently no national Australian screening program for strabismus, which makes it important for all general practitioners (GPs) to master practical skills for evaluating this condition. GPs should also be aware of red flags in a history and examination that necessitate prompt investigation and management.
OBJECTIVE
This article reviews practical screening tests to identify childhood strabismus, and discusses a framework for timely intervention.
DISCUSSION
A comprehensive history is used to distinguish between primary and acquired strabismus. The four tests used to screen for stra-bismus are the light reflex test, the red reflex test, the cover test and the uncover test. Any child diagnosed with strabismus should be referred to an ophthalmologist for further assessment.
Topics: Australia; Child; Diagnosis, Differential; General Practice; Humans; Medical History Taking; Physical Examination; Strabismus; Vision Tests
PubMed: 24324989
DOI: No ID Found -
Eye (London, England) Oct 2011Surgical management of strabismus remains a challenge because surgical success rates, short-term and long-term, are not ideal. Adjustable suture strabismus surgery has... (Review)
Review
Surgical management of strabismus remains a challenge because surgical success rates, short-term and long-term, are not ideal. Adjustable suture strabismus surgery has been available for decades as a tool to potentially enhance the surgical outcomes. Intellectually, it seems logical that having a second chance to improve the outcome of a strabismus procedure should increase the overall success rate and reduce the reoperation rate. Yet, adjustable suture surgery has not gained universal acceptance, partly because Level 1 evidence of its advantages is lacking, and partly because the learning curve for accurate decision making during suture adjustment may span a decade or more. In this review we describe the indications, techniques, and published results of adjustable suture surgery. We will discuss the option of 'no adjustment' in cases with satisfactory alignment with emphasis on recent advances allowing for delayed adjustment. The use of adjustable sutures in special circumstances will also be reviewed. Consistently improved outcomes in the adjustable arm of nearly all retrospective studies support the advantage of the adjustable option, and strabismus surgeons are advised to become facile in the application of this approach.
Topics: Anesthesia; Female; Humans; Male; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Reoperation; Strabismus; Suture Techniques; Sutures; Treatment Outcome
PubMed: 21760626
DOI: 10.1038/eye.2011.167 -
Indian Journal of Ophthalmology Mar 2017Strabismus is one of the most challenging subspecialties encountered in the field of ophthalmology. The concept of etiology of strabismus is being advanced with the... (Review)
Review
Strabismus is one of the most challenging subspecialties encountered in the field of ophthalmology. The concept of etiology of strabismus is being advanced with the development of newer imaging modalities and increased understanding of the genetics of strabismus. Imaging is also being used to aid in the planning of strabismus surgery. Newer horizons are being explored in the amblyopia management. The good old eye-pad is being replaced with the iPad. Early detection of loss of stereopsis is being used to decide the timing for strabismus surgery. Improvement of binocular summation has been discovered as a benefit of corrective strabismus surgery. Newer surgical techniques such as new transposition procedures are being developed to correct complex strabismus. Strabismus surgeries aided by adjustable sutures have increased the precision of a strabismologist. A new light has been thrown on the psychosocial impact of strabismus. A present-day strabismologist has advanced from the goal of ocular alignment to a bigger perspective "to regain the paradise lost: stereopsis."
Topics: Congresses as Topic; Eye Movements; Humans; Oculomotor Muscles; Strabismus; Vision, Binocular; Visual Acuity
PubMed: 28440246
DOI: 10.4103/ijo.IJO_867_16 -
American Journal of Ophthalmology Apr 2023To describe the characteristics and prevalence of strabismus and nystagmus in children diagnosed with cataracts using a national insurance claims database.
PURPOSE
To describe the characteristics and prevalence of strabismus and nystagmus in children diagnosed with cataracts using a national insurance claims database.
DESIGN
Population-based retrospective cohort study.
METHODS
Patients aged <13 years diagnosed with cataracts (traumatic cataracts excluded) and enrolled continuously in their health care program for ≥5 years after their first cataract diagnosis were identified in a retrospective review of 66 million charts in Optum's de-identified Clinformatics Data Mart Database between 2003 and 2015. Patients were categorized based on age of their first diagnosed cataract, and if cataract surgery was performed. Clinical and demographic factors associated with the occurrence of strabismus and nystagmus were evaluated.
RESULTS
Of 1636 children diagnosed with cataract, 434 (26.5%) and 109 (6.7%) were diagnosed with strabismus and nystagmus, respectively. Both strabismus and nystagmus were more common in those who underwent cataract surgery (P < .001) and in patients diagnosed with cataract at ≤12 months of age (P < .001). Survival analysis demonstrated that strabismus and nystagmus may be diagnosed 8 years after the initial cataract diagnosis. Cox proportional hazard regression analyses revealed strabismus was associated with cataract surgery, nystagmus, and the diagnosis with cataract at ≤12 months and cataract surgery at >12 months.
CONCLUSIONS
As strabismus and nystagmus occur more frequently in children diagnosed with cataracts necessitating cataract surgery, regular long-term follow-up is crucial for these children to monitor for the development of strabismus and nystagmus.
Topics: Child; Humans; Infant; Retrospective Studies; Visual Acuity; Cataract; Cataract Extraction; Strabismus; Nystagmus, Pathologic; Follow-Up Studies
PubMed: 36410473
DOI: 10.1016/j.ajo.2022.11.014 -
Acta Ophthalmologica Jun 2019The effect of maternal smoking during pregnancy on strabismus in offspring remains unclear. We conducted a meta-analysis to summarize epidemiological evidences on the... (Meta-Analysis)
Meta-Analysis Review
The effect of maternal smoking during pregnancy on strabismus in offspring remains unclear. We conducted a meta-analysis to summarize epidemiological evidences on the association between maternal smoking during pregnancy and the risk of offspring strabismus. Eligible studies were searched from the PubMed, Ovid, Embase and CNKI databases up to May 2018. The qualities of included articles were assessed with the Newcastle-Ottawa Scale and the assessment scale recommended by the Agency for Healthcare Research and Quality. Odds ratios (ORs) corresponding with its 95% confidence intervals (CIs) were pooled to estimate the effects of maternal cigarette smoking on the risk of offspring strabismus. Subgroup analyses and meta-regression were performed to explore the potential sources of heterogeneity. The Begg's test and Egger's test were used to assess the publication bias. Eleven articles involving 4,833 patients with strabismus were included. The pooled OR showed that maternal smoking during pregnancy was significantly associated with strabismus in offspring (OR = 1.46, 95% CI = 1.32-1.60). Compared with less than 10 cigarettes per day (OR = 1.17, 95% CI = 1.06-1.29), maternal smoking 10 cigarettes or more per day during pregnancy significantly increased the risk of offspring strabismus (OR = 1.79, 95% CI = 1.39-2.31). The risk of developing esotropia and exotropia for smoking pregnant women, respectively, increased by 65% (OR = 1.65, 95% CI = 1.31-2.09 and OR = 1.65, 95% CI = 1.24-2.19) than those who did not smoke during pregnancy. Additionally, the increased risk of maternity smoking associated with offspring strabismus was stable across all subgroup analyses. Overall, maternal smoking during pregnancy was associated with a significantly increased risk of offspring strabismus and the result was persistent in subgroup analyses, suggesting the importance in changing smoking habit or smoking cessation for women who are pregnant or preparing to.
Topics: Female; Global Health; Humans; Incidence; Infant, Newborn; Pregnancy; Prenatal Exposure Delayed Effects; Risk Factors; Smoking; Strabismus
PubMed: 30402966
DOI: 10.1111/aos.13953