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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prevalence of significant lateral incomitance in patients with nonparetic exotropia is reported to be 22%. We speculated that measurement artifact may be the cause for some cases of apparent lateral incomitance. We measured the effective power of plastic ophthalmic prisms using a helium-neon laser in the frontal plane position and at 10 degrees, 20 degrees, and 30 degrees of rotation from the frontal plane. The rotated prisms represented the situation in which a neutralizing prism rotates with the head during measurement of lateral gaze positions. For prisms of 35 prism diopters or more, even 10 degrees of rotation produced significant artifactual incomitance. For smaller prisms, 20 degrees or more of rotation was necessary to induce significant lateral incomitance. We prospectively measured 40 consecutive patients with exotropia. Only three patients (9%) had true incomitance greater than 5 delta, and only one had incomitance in both directions of gaze. Significant lateral incomitance could be induced in every patient examined by improperly positioning the neutralizing prism. Because the detection of lateral incomitance causes most strabismus surgeons to reduce the amount of surgery they perform, special care is necessary when measuring deviations in lateral gazes.
J Pediatr Ophthalmol Strabismus
PMID:Lateral incomitance in exotropia: fact or artifact? 189 May 67

Incontinentia pigmenti achromians is a multisystem hereditary disorder characterized specifically by a whorled or streaked cutaneous hypopigmentation and frequently characterized by numerous neurologic, musculoskeletal, and ocular abnormalities. We present a patient with incontinentia pigmenti achromians in whom the ocular abnormalities included the commonly reported exotropia, myopia, small optic nerve, and hypopigmentation of the fundus, as well as rarely reported corneal asymmetry, pannus, and atropic irides with irregular pupillary margins. The patient also had a cataract in the right eye and a retinal detachment in the left eye.
J Pediatr Ophthalmol Strabismus
PMID:The ocular changes of incontinentia pigmenti achromians (hypomelanosis of Ito). 189 May 74

Two patients developed exotropia with limited medial rectus function following endoscopic intranasal ethmoid sinus surgery. In both patients, fractures occurred in the medial orbital wall. The first patient required horizontal rectus muscle surgery to regain ocular alignment. The second required no surgery, but was left with limited horizontal motility secondary to scarring at the fracture site. While endoscopic techniques improve the surgeon's view of sinus anatomy, they do not eliminate the risk of entering the orbit and causing ocular complications.
J Pediatr Ophthalmol Strabismus
PMID:Strabismus following endoscopic intranasal sinus surgery. 189 May 76

We reviewed the postoperative alignment drift in 201 patients between the ages of 14 and 75 years who underwent rectus muscle surgery with adjustable sutures from 1984 to 1989. We analyzed results for 42 primary esotropia (ET) surgeries and 37 reoperations (groups IA and IB, respectively), 34 exotropia (XT) primary surgeries and 66 reoperations (groups IIA and IIB, respectively), and 22 hypertropia (HT) surgeries (group III). Forty percent of patients required postoperative muscle adjustment. All patients underwent a minimum of 8-weeks follow up; 66% underwent 6-months follow up or longer. The postoperative drifts in alignment for primary surgeries versus reoperations were not significantly different for either ET or XT patients. The mean postoperative drift in prism diopters from the alignment immediately after the adjustment, or after the surgery if no adjustment was needed, for each group as measured during the most recent follow up was 1.3 eso-shift for group IA, 1.2 exo-shift for group IB, 4.8 exo-shift for group IIA, 4.1 exo-shift for group IIB, and 1.5 hyper-shift for group III. Only for groups IIA and IIB were these drifts found to differ significantly from zero. Based on these drift patterns, we align ET patients to orthotropia, XT patients to 5 to 7 delta esotropic, and HT patients to 1 to 2 delta hypotropic positions.
J Pediatr Ophthalmol Strabismus
PMID:Stability of the postoperative alignment in adjustable-suture strabismus surgery. 191 67

To understand to what extent visual-pattern deprivation during infancy results in strabismus and nystagmus, the authors examined the long-term consequences of this type of deprivation in monkeys during the first 50 days of life. Three cynomolgus and three rhesus monkeys had the eyelids sutured closed within 24 hr of birth. At 25 days of age, the eyelids were opened, and the eyelids of the fellow eye were sutured closed for an additional 25 days (reverse-eyelid suture). When the eyelids were opened at 50 days of age, each monkey was found to have 20-30 delta of exotropia and nystagmus, which persisted for the duration of the study (1 yr). The cynomolgus monkeys developed a monocular 8-10 Hz pendular nystagmus in the eye sutured first. The rhesus monkeys developed a conjugate nystagmus with both jerk and pendular components. The slow phases often had velocity-increasing profiles. The rhesus monkeys also had a superimposed latent component to the nystagmus found during monocular viewing. One additional rhesus monkey was examined after 55 days of binocular-eyelid suturing. This monkey also developed exotropia and nystagmus resembling that of the other rhesus monkeys. These findings suggest that early pattern vision in monkeys is necessary for the development of normal ocular alignment and gaze-holding ability.
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PMID:Early visual deprivation results in persistent strabismus and nystagmus in monkeys. 198 95

We studied all cases of strabismus surgery performed at the Manhattan Eye, Ear and Throat Hospital between January 1, 1981 and June 30, 1986. Of the procedures, 106 (5.4%) were performed on patients over the age of 60 years. Strabismus in patients over age 60 represents a category of diseases which are different from those of childhood. Horizontal deviations were seen in 74% of the patients equally divided between esotropia and exotropia. Vertical strabismus was seen in 17%, and a combined vertical horizontal strabismus was seen in 9% of patients. In children, the overwhelming majority of ocular deviations are horizontal, with esotropias outnumbering exotropias. The strabismus was of adult onset in 71% of cases and of childhood onset in 29% of the patients. The etiology in the adult onset strabismus group included neuroparalytic, restrictive, sensory, and post-cataract surgery strabismus, as well as decompensated exophoria/intermittent exotropia; this was in contrast to children where the most common etiology of strabismus is innervational disturbances in fusional vergences. The major indications for surgery were diplopia and aesthenopia in 71% of cases. Diplopia is uncommon in childhood. Corrective surgery for the relief of diplopia may be enhanced with the use of adjustable sutures and postoperative prism therapy. Precise realignment is the goal of strabismus surgery in all age groups, however, the role of adjustable sutures and prisms is more important in the treatment of the functional complaints of older patients. Exploration and lysis of adhesions and scar tissue are major components of surgery on patients with restrictive strabismus.(ABSTRACT TRUNCATED AT 250 WORDS)
J Pediatr Ophthalmol Strabismus
PMID:Strabismus in patients over the age of 60 years. 201 55

Despite the emphasis placed on the vertical aspect of the deviation by its currently accepted clinical label, dissociated vertical deviation is well known to include movements in both the torsional and horizontal planes. When the horizontal component is very prominent, dissociated horizontal deviation is suggested as an appropriate label. We report the clinical characteristics and surgical treatment of six patients with a dissociated horizontal deviation that was marked enough to be the reason for seeking medical attention. All patients underwent lateral rectus recession unilaterally or bilaterally, alone or in combination with superior rectus recession. In addition, we report the use of the darkening wedge test to demonstrate the Bielschowsky phenomenon in the horizontal plane. This phenomenon, a dissociated exotropia spontaneously moving toward and crossing the midline to become an esotropia under cover when a progressively darkening filter is placed over the fixing eye, has not to our knowledge been previously reported.
J Pediatr Ophthalmol Strabismus
PMID:Dissociated horizontal deviation. 205 Dec 96

Latent/manifest latent nystagmus (LMLN) is a jerky type of nystagmus with the fast phase directed toward the fixating eye. A previous report described that the slow phase shows decreasing-velocity exponentials. However, it is sometimes difficult to differentiate between pure LMLN and latent nystagmus with congenital nystagmus. Furthermore, there has been no detailed report of quantitative analysis of the waveform of LMLN. Therefore, in the present study 18 cases with LMLN were clinically selected and their eye positions and/or strabismus were carefully studied. The eye movement was recorded by a photo-electric device. The patients fixated on a small white target placed at 0, 5, 10, and 15 degrees either from the center toward the right or toward the left in the horizontal plane. Eye movement in each position for at least one minute's duration was recorded on a floppy disc after being digitized by an A/D converter. Then, the time constant of the slow phases were estimated using the repetitive non-linear least square method by a personal computer (NEC, PC 9801). Details of the method have been described previously. The 18 cases were first classified into three groups, based on analysis of the slow phases; 1. decreasing-velocity type, 2. increasing-velocity type, and 3. combination of 1. and 2. In group 1. esotropia or intermittent esophoria was present in all cases (100%) and none of them had stereopsis. In group 2 on the other hand, exophoria or intermittent exotropia was present in 4 (51%) out of 7 cases, and 6 (96%) out of 7 cases had stereopsis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Quantitative analysis of the slow-phase in LMLN]. 208 37

Ten patients with small angle intermittent exotropia of 14 to 16 prism diopters were treated by unilateral lateral rectus muscle recession of 11.5 to 12 mm on the nondominant eye. In the immediate postoperative phase, overcorrection of 4 to 6 delta gave a very good functional result. Abduction deficiency was minimal for recession up to 12 mm. This procedure should be considered as an alternative approach in the treatment of small angle intermittent exotropia showing a "basic" pattern.
J Pediatr Ophthalmol Strabismus
PMID:Excessive single lateral rectus muscle recession in the treatment of intermittent exotropia. 208 49

Botulinum toxin A injection in essential blepharospasmus and hemifacial spasmus is an important alternative to surgical therapy. The toxin is injected into the lateral parts of the lower and upper lid in single doses of one to two nanograms under electromyographic control. The effect is visible after a few days and lasts for several months. The procedure can be repeated several times. A second important application of botulinum toxin A is strabismus. In paralytic strabismus the contracture of the antagonist of the paralyzed muscle can be weakened by local injection of botulinum toxin by means of a needle electrode under electromyographic control. Thus the contracture of the homolateral antagonist can be overcome and not seldom singular binocular vision obtained again. In cases of moderate pareses which recover spontaneously the muscle weakening effect of the toxin on the antagonist helps to restore binocular single vision. In cases of chronic paralytic strabismus the toxin injection into the antagonist facilitates the surgical intervention on the paralyzed muscle. In concomitant strabismus botulinum toxin A is above all valuable in small angle cases, in sensory strabismus, in cases of over- or undercorrection after surgery, and these especially in adults. In congenital esotropia, in commitant squints with large angles and in chronic or intermittent exotropia surgery is the preferred modality of treatment. The best results are obtained with repeated small doses. Generally a 65% reduction of the strabismus angle after two to three injections can be expected. With injections into the lids and the extraocular muscles no general systemic side effects has been observed.
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PMID:[Use of botulinum toxin in ophthalmology]. 219 66


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