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At least 19 recordsLinked to original sources
PubMed1999

[Concomitant strabismus: of strabismus in strabismus syndromes].

PURPOSE: To show how to progress from the deviation of the visual axis (provided the diagnosis of concomitant strabismus is certain) to the classification of the squint in one out of the different squint syndromes and consequently to adopt the appropriate therapeutic strategy. METHOD: Every sign correlated with the deviation contributes to progress step by step to the diagnosis of a given squint syndrome. The age on onset of strabismus, either convergent or divergent, and its characteristic, intermittent or constant, allow in a first step to evaluate the potential binocularity, as well in early as late (acquired) strabismus. The first group of early strabismus includes manifest infantile strabismus and microstrabismus. Both have abnormal binocularity. The possibility of functional amblyopia, angle variability and additional incomitances have to be investigated. Early intermittent strabismus keeping a potential normal binocularity are seldom. In the second group of late onset strabismus, retinal correspondence has to be investigated by correspondence tests and prism or bifocus compensation to distinguish between the two possible types (including the accommodative forms of strabismus), i.e. decompensated microstrabismus with abnormal binocularity or normosensorial strabismus with potential normal binocularity. In some cases potential binocularity may be initially uncertain and/or remain later on subnormal. RESULTS: As the result of this systematic approach, every cases of squint can be classified in one out of the different squint syndromes. Based on the precise diagnosis, the appropriate treatment can be carried out. The goals of treatment which can be reached in every syndrome are indicated. DISCUSSION: For an overall view of the squint syndromes a classification with two entrances are necessary, on the one hand early or late onset, on the other hand normal or abnormal binocular conditions. CONCLUSION: This approach of concomitant strabismus should serve as guide lines for clinical practice.

Adolescent↗
PubMed2002

[Amblyopia in myopia in patients with strabismus and without strabismus].

PURPOSE: To determine factors, which have influence on presence of strabismus among myopic patients with amblyopia. MATERIAL AND METHODS: Material covers 21 myopic patients with amblyopia, aged 6-15. All children presented have a different amount of anisometropia, 12 of them had strabismus. Authors, compared the group of patients with amblyopia and strabismus (12) with the group of patients with pure anisometropic amblyopia (9), according to the following criteria: age of presentation, best corrected visual acuity, mean refraction error of amblyopic eye, mean amount of anisometropia, percentage of patients with central fixation and binocular vision. RESULTS: Patients with strabismus presented oneself earlier than patients without squint. Best corrected visual acuity was better in patients without strabismus. Refraction error in both groups has similar value. Amount of anisometropia was slightly smaller in the group with squint. Central fixation and binocular vision were better preserved among patients without strabismus. Authors didn't find the following correlations too: correlation between amount of anisometropia and amount of amblyopia in both groups, correlation between amount of anisometropia and the amount of the deviation of squinting eye, correlation between depth of amblyopia and the amount of deviation of the squinting eye. CONCLUSION: It seems, that primary factor leading to presence of strabismus among patients with anisometropic myopia, is motor dysfunction of extraocular muscles.

Adolescent↗
PubMed1999

Inheritance of strabismus and the gain of using heredity to determine populations at risk of developing strabismus.

PURPOSE: In the Nordic countries 2 to 4% of the population squint or have been squinting. Since strabismus is one of the major causes of amblyopia early detection and treatment is important for preventing this development. For centuries it has been recognized that strabismus is hereditary. Identifying individuals with a family history of squinting could give access to a risk population for a selective screening. METHODS AND RESULTS: 1,571 children were selected for this study. All children that took part in a voluntary eye examination at one year of age (born 1978-1983) in the city of Vasteras, Sweden and that had a family history of strabismus were selected together with controls. The study was a 6-year follow-up from 1 to 7 years of age. Parental knowledge of squint among relatives and measured high hyperopia (>3.0 D) present at 1 year of age were each and in combination evaluated as a risk indicator for development of strabismus between 1 to 7 years of age. CONCLUSION: The study indicates that a family history of squint in combination with measured high hyperopia can be used in a selective screening to identify a population with an increased risk of 4 to 6 times for developing strabismus. Among the children with parental knowledge of squint among several relatives of both the parents, those with high hyperopia developed strabismus in almost every second case while this was the case in only approximately 10% of those with low hyperopia. Finally, heredity is an important risk indicator that can be used for selective screening purpose. Its potential as a risk indicator is substantially increased when combined with a high hyperopia.

Child↗
PubMed1980

[Sensory binocular relationships in divergent strabismus and convergent strabismus].

The adaptive processes mentioned here (which include inhibitory phenomena and modifications in spatial localization) were observed, using a stereoprojector which polarized light. Comparing the adaptive processes in convergent and divergent strabismus has led to the following observations: (1) there are differences between the two types of strabismus; these differences appear not only at the level of the binocular sensory parameter but also at the level of motor and accommodative parameters; adaptive processes are less deep and less serious in divergent and strabismus; these differences are also manifest in therapy: divergent strabismus is curable whatever the age, treatment is much shorter. These observations were the starting point for using prismatic overcorrection to induce a state of 'sensory divergence' as treatment in cases of convergent strabismus with anomalous retinal correspondence. The excellent results obtained using this method of treatment are not only due to the action on sensory binocular relations, but also to the fact that prismatic overcorrection also modifies abnormal motor patterns. Treating strabismus must involve the entire disturbed optico-sensorimotor complex.

Accommodation, Ocular↗
PubMedDate not supplied

Clinical features of comitant strabismus related to family history of strabismus or abnormalities in pregnancy and delivery.

PURPOSE: To elucidate the genetic or environmental background for clinical features in the three major types of comitant strabismus. METHODS: Interview based on a questionnaire asking background factors such as family history of strabismus and abnormalities in pregnancy and delivery was conducted with 101 consecutive patients with infantile esotropia (5-180 months of age), 83 with accommodative or partially accommodative esotropia (6-201 months of age), and 143 with intermittent exotropia (3-216 months of age) seen during 7 months from May to November 1998. The clinical features of strabismus obtained from medical records were analyzed statistically by logistic regression to determine their relation with these background factors. RESULTS: In infantile esotropia, patients with family history of strabismus had a significantly higher chance of showing latent nystagmus (odds ratio, 3.553; 95% confidence interval [CI], 1.077-11.717; P =.0373, logistic regression analysis). In a subgroup of 40 patients with infantile esotropia whose birth followed no abnormalities in pregnancy or delivery, patients with family history of strabismus had a significantly higher chance of showing inferior oblique muscle overaction (odds ratio, 7.714; 95% CI, 1.246-47.761; P =.0280), dissociated vertical deviation (odds ratio, 6.667; 95% CI, 1.176-37.787; P =.0321), and latent nystagmus (odds ratio, 7.333; 95% CI, 1.168-46.060; P =.0336). In accommodative or partially accommodative esotropia and intermittent exotropia, no relation was found between the clinical features and the background factors. CONCLUSIONS: Inferior oblique muscle overaction, dissociated vertical deviation, and latent nystagmus in infantile esotropia might have a genetic background.

Adolescent↗
PubMed1990

A longitudinal study of children with a family history of strabismus: factors determining the incidence of strabismus.

A longitudinal study of ocular refraction, position, and fixation was performed in children with a family history of strabismus. The children were examined at regular intervals between 3 months and 4 years of age, and the results are discussed in terms of changes in refraction between different ages and correlations between refraction and development of strabismus and amblyopia. Six of 34 children (17.6%) developed constant or intermittent esotropia. The strabismus was first noted between 18 and 30 months of age except in one case. All esotropic children were 4 dioptres hypermetropic or more at 6 months, and their hypermetropia remained almost unchanged through the years. Seven additional children were 4 dioptres or more hypermetropic at 6 months but did not develop a squint. In contrast to the squinting children the hypermetropia in these children changed towards emmetropia. This emmetropisation was most pronounced during the first 2 years of age. The implications of these results for an early diagnosis of strabismus amblyopia are discussed.

Aging↗
PubMed1999

[Amblyopia without strabismus in context of research on concomitant strabismus].

PURPOSE: To evaluate pathogenic factors for unilateral amblyopia in the group of amblyopic patients without strabismus. MATERIAL AND METHODS: In the study 141 patients with unilateral amblyopia without strabismus were evaluated according to age, sex, visual acuity, refraction error, presence of anisometropia, age of mother on delivery, weight on birth, hereditary transmission of strabismus or refractive error, pregnancy and delivery complications, response to treatment. RESULTS: Serious birth and pregnancy complications were noted only in 14.2% of cases, hereditary transmission might be suspected in 41.2% of patients. Anisometropia was found in 72% of cases. No significant difference in prevalence of possible pathogenic or risk factors such as age, sex, birth-weight, age of mother on delivery, hereditary transmission, pregnancy or delivery complications were found between anisometropic and isometropic group. Anisometropic group had bigger refractive error and deeper amblyopia, but responded better to treatment. CONCLUSION: Etiology of amblyopia without strabismus, particularly in the group of patients with isometropia, should be associated with trauma to central nervous system either in pre-natal or early after birth period.

Adolescent↗
PubMed1985

Clinical comparison of congenital or early onset paretic vertical strabismus vs. acquired paretic vertical strabismus.

Thirty-five patients having paretic vertical strabismus were evaluated to determine which clinical parameters could best be used to differentiate congenital or early onset vertical strabismus from late onset vertical strabismus. Those patients with late onset deviations had a higher incidence of diplopia, a higher incidence of cyclodeviation, a higher incidence of compensatory head posture, and manifested larger vertical deviations in the primary position. However, the degree of incomitance, the prevalence of amblyopia, and the level of stereoacuity, did not distinguish the two patient groups. Prism therapy was equally successful for both groups.

Adolescent↗
PubMed2001

Strabismus surgery in the treatment of paralytic strabismus.

Strabismus surgery may restore limited binocular function and improve cosmesis in patients with paralytic strabismus. Evaluation of the amount of residual function of the affected extraocular muscles is essential to determine which surgical procedure will yield the best results. Standard muscle resection techniques are effective for patients who have paretic extraocular muscles with residual function. Muscle transposition procedures are indicated for patients with total paralysis of an extraocular muscle. Autogenous and alloplastic materials may be required to fix the eye in primary position in patients with total paralysis of multiple extraocular muscles. This article discusses the recent literature regarding the evaluation and management of patients with paralytic strabismus. Current concepts regarding extraocular muscle transposition and the use of autogenous materials are emphasized.

Humans↗
PubMed1992

[Length-tension measurement of oblique eye muscles in strabismus operations for differentiating trochlear paralysis and strabismus sursoadductorius].

In a group of patients with a motility typical of a superior oblique palsy (a hypertropia increasing in adduction, in down-gaze and on head-tilt, a V-pattern and an excyclotropia), we recorded length-tension diagrams of oblique eye muscles during strabismus surgery. In 14 cases a length-tension recording was made during surgery in general anaesthesia, before and after intravenous administration of succinylcholine, that produces a fierce contraction of eye muscles. Among 14 patients that had eye motilities compatible with a superior oblique muscle palsy, 7 indeed had a non-contracting superior oblique muscle, but others had oblique muscles that contracted vividly. We also made length-tension diagrams of oblique eye muscles during strabismus surgery with local, tetracain eye-drop anaesthesia. Here, the recording was made three times, while the patient looked ahead, into the field of action of the muscle and out of the field of action of the muscle. Some patients indeed had a non-contracting superior oblique muscle and a stiff inferior oblique muscle, but others had superior oblique muscles that contracted vividly, despite an eye motility typical of a superior oblique palsy, with a positive Bielschowsky head-tilt test. This finding confirms the assumption of Kaufmann, Kolling and others that these cases have a non-paretic motility disorder. Viirre et al. found in normal monkeys that disruption of fusion by one week of occlusion of one eye allowed abberrations of conjugate horizontal and vertical eye movement like upshoot-in-adduction to become manifest.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1980

[New viewpoints on the pathogenesis and the treatment of strabismus. First part: pathogenesis of strabismus (author's transl)].

In 1962 the anteroposition of the inferior oblique muscle has been introduced. This surgery enlarges the angle between the muscle and the visual axis favouring the torsional action at the cost of the vertical one. The results of 554 cases with a postoperative follow-up of at least ten years are analysed. The spontaneous recovery of binocular vision and the disappearance of the accommodative component suggest that a sagittalization of the oblique muscles might be an important cause of strabismus. The evolution of the suppression scotoma demonstrates that the position of the eyes depends on the optomotor balance between the nasal and temporal retinal halves. A new concept of the pathogenesis of squint is presented. The sagittalization of the oblique muscles and the hemiretinal suppression are considered to be the keys by means of which the problem of strabismus could be solved.

Adult↗
PubMed1998

The Early vs Late Infantile Strabismus Surgery Study: do sources for bias exist in this non-randomised trial? Early vs Late Infantile Strabismus Surgery Study Group.

BACKGROUND: The Early vs Late Infantile Strabismus Surgery Study Group investigates whether early or late surgery is preferable in infantile convergent strabismus, in a non-randomised, prospective, multicentre clinical trial. The current state of the study after end of recruitment is reported here, focusing on the question of possible sources for bias in this non-randomised trial. METHOD: The prognostic factors were analysed at baseline in order to check for imbalances between the two treatment groups. Reasons for possible differences are discussed. RESULTS: There is no evidence for clinically relevant inhomogeneities between the two groups concerning the distribution of the three prognostic factors spherical equivalent, degree of amblyopia, and limitation of abduction. The fourth prognostic factor, horizontal angle of squint, differs significantly between the two groups. CONCLUSION: In the analysis of the final results we may have to account for differences in angle of squint at baseline by its inclusion as a covariate or by stratification.

Age Distribution↗
PubMed1989

Long-term results after strabismus surgery in convergent strabismus.

The results of surgery in 714 patients with convergent strabismus from a private practice are presented. In 90.2% one operation was enough. The minimum follow-up is 3 years, the average follow-up is 9.2 years. The age of onset of strabismus and the binocular status are the key factors for prognosis. The first factor cannot be influenced through therapy, the second can be. The pre- and postoperative treatment is of utmost importance on the sensory result and on the surgery itself.

Age Factors↗
PubMed1981

[New view points on the pathogenesis and treatment of strabismus. 2nd part: Management of strabismus (author's transl)].

A new method of surgical treatment of strabismus is presented. The desagittalisation of the oblique muscles is the main part of surgery; it is associated to surgery of the horizontal recti muscles and sometimes to surgery of the vertical recti muscles. The surgical procedures are described; the indications are set up for the primary surgery as well as for the secondary surgery which aims at the treatment of under and over corrections.

Adult↗