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At least 1,117 records · Page 62Linked to original sources
PubMed1995

[Role of topical anesthesia in strabismus surgery].

The use of topical anesthesia for strabismus surgery can be useful in selected, cooperative patients. This technique is always performed on an ambulatory basis, and the surgical time rarely exceeded 30 minutes. One of the major advantages of this type of procedure is the ability to adjust the sutures during the operation. The presence of diplopia is a major indication for topical anesthesia. The use of Gracis grids has proved extremely useful for assessing the dynamic evolution of the diplopia over the various visual fields during the operation. This allows the surgeon to better control his correction, with horizontal, vertical, or torsional diplopia. Finally, this study shows that a precise clinical examination allows excellent results while limiting surgery to a single muscle (in 12 of the 14 cases).

Administration, Topical↗
PubMed1996

[Diplopia as a complication after surgery for strabismus in adolescents and adults].

Diplopia may occur following surgery for the correction of constant manifest strabismus. Young children rarely complain of diplopia because of the plasticity of their visual system and the rapid development of suppression. However, in older children and adults post-operative diplopia may occur either as a transient well-tolerated phenomenon or occasionally as an intractable problem. It is a standard practice to carry out tests prior to surgery to try and predict the risk of post-operative diplopia, although the value of these tests and the incidence and severity of diplopia following squint surgery is not well documented. We reviewed the records of these 22 out of all our patients operated for squint who had diplopia (aged 13-45). 13 subjects presented diplopia only for 1 or 2 days after surgery 8 had intermittent one with good tolerance and 1 acquired constant diplopia (she was operated). Pre- and post-operative agents which could have had an impact on diplopia occurrence were evaluated. Diplopia was found in 48% patients who had positive test predicting the risk of post-operative diplopia. The test thus seems to be quite limited in its reliability and prior to surgery the patients should be thoroughly informed about a possibility of diplopia occurring as a surgery complication.

Adolescent↗
PubMed1977

[The effect of euthyscope- and occlusion therapy in cases of convergent strabismus. Comparative, prospective examinations (author's transl)].

1. 63 children with strabismus and amblyopia (average age 7 years) were chosen at random to be treated either with occlusion or with the Euthyscope followed by occlusion. No significant difference was apparent after comparison of both forms of treatment. 2. Six more children were occluded for several months without success and were then treated for two months with the Euthyscope followed by further occlusion. In four of these cases pleoptic treatment proved to be temporarily successful. 3. In addition, 14 children with microstrabismus and amblyopia, and 17 children with amblyopia ex anisometropia showed a distinct improvement of the visual aciuty after occlusion. An 18-year-old patient with microstrabismic amblyopia achieved normal visual acuity. 4. Euthyscope treatment was used in amblyopic patients who had lost their good eye. In the case of an 18-year-old patient the distant visual acuity increased to 0.6. The increase in the near vision and the speed of reading continued to improve for several years. 5. Papilla-Macula-Relationship: 47 amblyopes were compared with 8 anisometropic and 16 microstrabismic patients as well as with 32 normal subjects. In these groups no significant difference in the papilla-maculadistance was apparent. 6. Refraction: In amblyopic eyes there were no significant refractive errors between fixing and non-fixing eyes. Conversely, in patients with microstrabismus and those with anisometropic a significant difference was found.

Adolescent↗
PubMed1977

[On ketamine-monoanaesthesia for operations for strabismus in childhood (author's transl)].

In 58 children below the age of 12 with strabismus operations were performed under anesthesia with Ketamine. Continuous and discontinuous modes of application were selected with varying premedication. Blood-pressure and pulse-rate, the occurence of oculo cardial reflex (OCR) and narcotic requirement were registered and discussed with regard to premedication and specific modes of application.

Age Factors↗
PubMed1997

The effect of edrophonium chloride on muscle balance in normal subjects and those with nonmyasthenic strabismus.

Because the Lancaster red-green test and the Hess screen are not widely used by most ophthalmologists, we used the alternate prism-cover test to study the effect of intravenous edrophonium chloride (Tensilon) on the ocular alignment of 30 normal subjects and 14 individuals with nonmyasthenic strabismus. After measurement of their baseline phorias and tropias, patients received an intravenous injection of Tensilon via the incremental dose technique until autonomic effects of the drug were noted or until 10 mg was administered. Another set of measurements of muscle balance was taken immediately postinjection and 2 and 5 min later. Apart from a small increase (mean, 2 prism dipoters; p = 0.004) in their exophoria at near, normal subjects exhibited no significant change in their phorias after Tensilon injection. One third to one half of the nonmyasthenic strabismics, however, showed a change in their vertical deviation after Tensilon (46% at distance and 38% at near), with the majority of them increasing their angle of squint. These changes were small (mean, 1.7 prism diopters; maximum, 5 prism diopters). In only one case did reversal of the direction of deviation occur. Tensilon produces a statistically significant increase in near exophorias of normal subjects and in vertical distance deviations of nonmyasthenic strabismics. These changes, however, are clinically insignificant and should not be considered to constitute a positive Tensilon test.

Adolescent↗
PubMed1997

Diclofenac vs oxybuprocaine eyedrops for analgesia in paediatric strabismus surgery.

Forty children undergoing strabismus surgery as day patients were randomly allocated to receive oxybuprocaine 0.4% eyedrops or 0.1% diclofenac eyedrops for perioperative analgesia. A non-invasive anaesthetic technique using the reinforced laryngeal mask airway was used. The study demonstrated that both topical analgesics provided good to excellent analgesia and the anaesthetic technique was associated with a relatively low incidence of nausea and vomiting. Complications were limited to two children who were admitted with persistent postoperative nausea and vomiting.

Ambulatory Surgical Procedures↗
PubMed1977

Emotional factors in strabismus.

Emotional disturbance may cause strabismus which disappears when the disturbance is relieved. It is frequently the cause of a deterioration in the control of an esotropia particularly that associated with a high AC/A ratio. Two cases are reported. In the first, a concomitant esotropia was present in an adult with paranoid schizophrenia. This resolved completely after psychiatric treatment. The second case resembled a lateral rectus palsy. This also resolved on psychiatric treatment.

Adult↗
PubMed1998

Anomalous correspondence--the cause or consequence of strabismus?

I hypothesize that the functional role of binocular correspondence, whether normal or anomalous, is that of detecting retinal disparity stimuli. Normal correspondence involves disparity stimulus detection that is quantitatively normal and stable, whereas anomalous correspondence involves disparity detection that is quantitatively abnormal and variable. Normal disparity stimuli typically produce motor fusion between normally corresponding biretinal areas. The result is orthotropia, which permits normal single binocular vision and acute stereopsis. In contrast, abnormal disparity stimuli typically produce motor fusion between anomalously corresponding areas. The result is strabismus, usually coupled with anomalous single binocular vision (harmonious anomalous correspondence). Accordingly, corrective prism or muscle surgery only produces vergence movements that restore anomalous motor fusion, rather than eliminating the heterotropia. The inference is that anomalous correspondence involves a neurological disorder in the disparity detection mechanism, either on the convergent side (estropia with anomalous correspondence) or divergent side (exotropia with anomalous correspondence).

Brain Diseases↗
PubMedDate not supplied

[New method of visual fields color division in diploptic treatment of strabismus].

A new method of color division of the visual fields based on polarized light interference is described. A new method for diploptic therapy of strabismus is developed, based on the above principle and possessing numerous advantages. The method was used in 38 patients with binocular disorders of various severity; binocular function improved in 18. The method is particularly effective in the patients with correct position of the eyes with bifoveal fusion on the synaptophore and parallel color test vision and in the patients with binocular vision and amblyobinopia.

Child↗
PubMed1998

Myopia, hypotony, and lenticular shift following strabismus surgery.

A 5-year-old girl had hypotony, myopia, and anterior displacement of the lens-iris diaphragm following routine strabismus surgery. This constellation of findings suggests that surgical manipulation of the intact sclera produced a limited effusion involving the supraciliary space. Following cycloplegia, these findings resolved over several weeks, suggesting that this rare complications is self-limited and associated with a good prognosis for recovery.

Anterior Chamber↗
PubMed1997

Epidemiology of strabismus.

In a survey of around 60,000 optometric eye examinations, each with orthoptic assessment, 5% of patients were found to have a binocular vision anomaly. The frequency of each anomaly was found and an estimate was made of its prevalence in the general population. The prevalence rates are generally similar to other studies but are given in more detail. Of 3,075 binocular anomalies 74% had concomitant strabismus, 10% were paretic, 8% had decompensated heterophoria and 6% convergence insufficiency.

Humans↗
PubMed1998

Neuronal correlates of amblyopia in the visual cortex of macaque monkeys with experimental strabismus and anisometropia.

Amblyopia is a developmental disorder of pattern vision. After surgical creation of esotropic strabismus in the first weeks of life or after wearing -10 diopter contact lenses in one eye to simulate anisometropia during the first months of life, macaques often develop amblyopia. We studied the response properties of visual cortex neurons in six amblyopic macaques; three monkeys were anisometropic, and three were strabismic. In all monkeys, cortical binocularity was reduced. In anisometropes, the amblyopic eye influenced a relatively small proportion of cortical neurons; in strabismics, the influence of the two eyes was more nearly equal. The severity of amblyopia was related to the relative strength of the input of the amblyopic eye to the cortex only for the more seriously affected amblyopes. Measurements of the spatial frequency tuning and contrast sensitivity of cortical neurons showed few differences between the eyes for the three less severe amblyopes (two strabismic and one anisometropic). In the three more severely affected animals (one strabismic and two anisometropic), the optimal spatial frequency and spatial resolution of cortical neurons driven by the amblyopic eye were substantially and significantly lower than for neurons driven by the nonamblyopic eye. There were no reliable differences in neuronal contrast sensitivity between the eyes. A sample of neurons recorded from cortex representing the peripheral visual field showed no interocular differences, suggesting that the effects of amblyopia were more pronounced in portions of the cortex subserving foveal vision. Qualitatively, abnormalities in both the eye dominance and spatial properties of visual cortex neurons were related on a case-by-case basis to the depth of amblyopia. Quantitative analysis suggests, however, that these abnormalities alone do not explain the full range of visual deficits in amblyopia. Studies of extrastriate cortical areas may uncover further abnormalities that explain these deficits.

Amblyopia↗
PubMed1976

Preoperative evaluation of the strabismus patient.

The preoperative evaluation of the strabismus patient may require one or several examination sessions. Since general anesthesia is most often employed, the patient's general health, hematological and neurological status, and concurrent medications should be evaluated. The age of onset and whether the deviation was intermittent in character for some part of its course are important clues to fusion potential. The examination should emphasize close observation of the eyes when they are stationary and during rotations; it should be conducted so as to encourage, rather than frustrate, binocular cooperation. This requires test selection that takes into account both variations in alignment (at different test distances) and amblyopia. Sensory evaluation can involve many tests, but specifically for surgical planning it can be brief and apply principal to justification of surgery for small-angle, nonsymptomatic deviations. The phenomenon of intractable diplopia is unusual and probably should not be considered a strong deterrent to surgical correction of a long-standing and cosmetically unpleasant misalignment.

Humans↗
PubMedDate not supplied

[Computer treatment of strabismus and amblyopia using random-dot stereograms].

Application interactive CLASS software for stimulating productive binocular cooperation based on random-dot patterns and stereograms was used for treating strabismus and amblyopia in 105 children during a standard course of treatment. The children were divided into 3 groups treated by the CLASS alone (1), Class + two other application programs (2), and CLASS + traditional methods. General positive changes (improvement of visual acuity, decrease of eye deviation, etc.) were similar in these 3 groups. Positive effect of CLASS exercises on binocular visual mechanisms was significant. Due to precise evaluation of binocular interaction provided by CLASS, positive changes in binocular cooperation and stereovision were attained in 93% of children.

Amblyopia↗
PubMed1998

[Study and analysis of a population of multi-operated strabismus].

We present a retrospective study of 28 consecutive patients who where operated three times or more with a total amount of operations of 99 (mean: 3.7). The main factors leading to a reoperation rate were analysed and discussed. Most of the patients were presenting a congenital pathology (96.5%) associated with early onset strabismus (85.7%) or superior oblique palsy (14.2%). The main factors for reoperations were DVD (78.5%), recurrence of esotropia (42%) and consecutive exotropia (32%).

Adolescent↗
PubMed1976

[Convergent strabismus in the age of presbyopia (author's transl)].

Based on 15 case reports it can be shown, that the onset of a convergent squint is even possible in the age of presbyopia, independent of the patient's refraction. The clinical picture resembles that of a divergence paralysis or the convergent strabismus of the Bielschowsky type. In 13 cases the decompensation of a previous esophoria may have caused this distance-esodeviation; a divergence paralysis is not probable. In two cases change of orthophoria to esotropia could be observed. Therefore we share the opinion of v. Graefe, that an increased tonicity of the internal recti induced for compensation of weak convergence in aged individuals may cause esotropia. Treatment with prisms for distant vision is easy and effective. No case required surgery.

Aged↗
PubMed2002

The planar cell polarity gene strabismus regulates convergence and extension and neural fold closure in Xenopus.

We cloned Xenopus Strabismus (Xstbm), a homologue of the Drosophila planar cell or tissue polarity gene. Xstbm encodes four transmembrane domains in its N-terminal half and a PDZ-binding motif in its C-terminal region, a structure similar to Drosophila and mouse homologues. Xstbm is expressed strongly in the deep cells of the anterior neural plate and at lower levels in the posterior notochordal and neural regions during convergent extension. Overexpression of Xstbm inhibits convergent extension of mesodermal and neural tissues, as well as neural tube closure, without direct effects on tissue differentiation. Expression of Xstbm(DeltaPDZ-B), which lacks the PDZ-binding region of Xstbm, inhibits convergent extension when expressed alone but rescues the effect of overexpressing Xstbm, suggesting that Xstbm(DeltaPDZ-B) acts as a dominant negative and that both increase and decrease of Xstbm function from an optimum retards convergence and extension. Recordings show that cells expressing Xstbm or Xstbm(DeltaPDZ-B) fail to acquire the polarized protrusive activity underlying normal cell intercalation during convergent extension of both mesodermal and neural and that this effect is population size-dependent. These results further characterize the role of Xstbm in regulating the cell polarity driving convergence and extension in Xenopus.

Amino Acid Sequence↗
PubMed2003

Intraocular lens implantation during infancy: perceptions of parents and the American Association for Pediatric Ophthalmology and Strabismus members.

BACKGROUND: To determine whether a randomized clinical trial, the Infant Aphakia Treatment Study, comparing intraocular lens (IOL) implantation with contact lens (CL) correction for infants with a unilateral congenital cataract (UCC), is feasible by (1) ascertaining whether American Association for Pediatric Ophthalmology and Strabismus (AAPOS) members have equipoise regarding these two treatments and (2) evaluating the willingness of parents to agree to randomization. METHODS: All AAPOS members were surveyed in August 1997 and again in June 2001 regarding their use of CLs and IOL implants to correct infants vision after unilateral cataract surgery. In addition, a pilot study was begun in March 2002 to evaluate the safety of IOL implantation during infancy and the willingness of parents to randomize their children with a UCC to either IOL implantation or CL correction. RESULTS: In 1997, 89% of the 260 respondents reported that in the previous year they had treated at least one infant with a UCC, but only 4% had implanted an IOL in an infant <7 months old. Silsoft (Bausch & Lomb, Rochester, NY) CL correction was the preferred treatment choice for 84% of the respondents. In 2001, 21% of the 279 respondents had implanted an IOL in an infant. On a scale from 1 to 10 with 1 strongly favoring an IOL implant and 10 strongly favoring a CL, the median score was 7.5. Sixty-one percent of the respondents indicated that they would be willing to randomize children with a UCC to one of these two treatments. The main concerns about IOL implantation were poor predictability of power changes, postoperative complications, inflammation, and technical difficulty of surgery. The main concerns about CL correction were poor compliance, high lens loss rate, high cost, and keratitis. In our pilot study, 30 infants <7 months of age were evaluated at nine clinical centers for a visually significant UCC. Of 24 infants eligible for randomization, the parents of 17 (71%) agreed to randomization. CONCLUSIONS: Although most AAPOS members still favor CL correction after cataract surgery for a UCC, five times as many had implanted an IOL in an infant in 2001 compared with the number in 1997. Parents were almost equally divided in their preference for IOL implant versus CL correction. Given the relative equipoise of AAPOS members regarding these treatments and the willingness of more than two thirds of parents to agree to randomization, it seems likely that a randomized clinical trial comparing these two treatments could indeed be conducted.

Aphakia, Postcataract↗