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

A transfer procedure is very useful in the treatment of strabismus. The most common use of this procedure is to augment an already planned resection or recession procedure so that it can be performed monocularly to reduce an accompanying hypertropia or hypotropia or to collapse the A or V pattern when horizontal surgery is being performed for estropia or exotropia. In transfer procedures, the resultant change of deviation and cosmetic improvement is good or excellent in almost all cases. Some special transfer procedures, such as the Harada-Ito or the Jensen operation, can have dramatic effects on both comfort and change of symptoms for the patient.
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PMID:Transposition procedures in strabismus. 350 17

The results of bilateral medial rectus rerecession and bilateral lateral rectus resection for patients with undercorrected or recurrent esotropia after medial rectus recession are compared. Medial rectus rerecession resulted in a high rate of consecutive exotropia. Lateral rectus resection was more accurate but was often accompanied by undercorrection. Minimal millimeter amounts of rerecession yielded large diopter results. Except in cases where medial restrictive factors or obvious errors in magnitude of the original surgery are noted, we feel that bilateral lateral rectus resection is the surgery of choice in patients with recurrent or undercorrected esotropia following medial rectus recession.
J Pediatr Ophthalmol Strabismus
PMID:Reoperations for esotropia. 359 34

Between July 1984 and March 1985, 51 injections of type A botulinum toxin were given to 39 patients aged 11 to 81 years with various types of strabismus, including paralytic strabismus, sensory exotropia, consecutive and residual postsurgical deviations and partially accommodative esotropia. All deviations were documented by orthoptic assessment and photography. After treatment the patients were followed for up to 3 years. The beneficial effects of a single injection were modest, and a second injection was often necessary to achieve satisfactory ocular alignment. Thirteen of the 26 patients (50%) with nonparalytic strabismus and 10 of the 13 patients (77%) with paralytic strabismus had a good outcome (final deviation 12 prism dioptres or less). Adverse side effects included transient ptosis and diplopia and inadvertent vertical deviation. Twenty-one consecutive cases of nonparalytic horizontal strabismus treated with adjustable sutures were also reviewed. The results in these patients were more predictable and longer lasting than those in the patients who received botulinum toxin.
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PMID:Injection of type A botulinum toxin into extraocular muscles for correction of strabismus. 360 94

Despite the close association of convergence and accommodation, accommodative dysfunction is not often associated etiologically with exotropia. We studied 13 adolescent and young adults having intermittent exotropia and severely reduced accommodative function. Most patients had a prolonged history of visual symptoms that had not responded to therapy in the past. Clinical testing indicated that the patients had severely reduced amplitudes of accommodation and difficulty sustaining accommodation. Exotropia was manifest when the accommodative response was inadequate; relative orthophoria existed when the accommodative response was adequate. Treatment of the accommodative defect as well as the strabismus was successful for some patients. We recommend careful evaluation of accommodation for adolescent and young adults with exotropia to rule out an accommodative defect as a contributing cause.
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PMID:Exotropia associated with defective accommodation. 366 52

Botulin toxin A was introduced as a treatment in ophthalmology by Dr. Scott of San Francisco. One important application is in cases of blepharospasm, where the toxin is injected into the lateral parts of the lower and upper lid and, if necessary, over the eyebrows in a single dose of 1-2 nanograms, preferably using a needle under electromyographic control. The effect on the blepharospasm is visible after a few days and lasts for several months. The procedure can be repeated several times. The second application is in cases of strabismus. In paralytic strabismus, contracture of the antagonist of the paralyzed muscle can be weakened by local injection of botulin toxin with a coaxial electrode under electromyographic control. Good results were observed in cases of eye muscle disorders in endocrine ophthalmopathy. In concomitant strabismus (exotropia or esotropia) administration of botulin toxin is also possible although a certain paresis of the injected muscle has to be taken into account. The doses for strabismus vary between 1/2 and 2 nanograms of the toxin. The administration of botulin toxin either in blepharospasm or strabismus has no systemic side effects and is a safe procedure if performed under careful electromyographic control. First personal experiences in the treatment both of blepharospasmus as well paralytic strabismus and concomitant strabismus are reported.
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PMID:[Use of botulinum toxin in ophthalmology]. 371 87

Ten years post-operative follow-up of 25 consecutive patients with intermittent exotropia have been performed. 13/25 patients are at follow-up fine, that is small and symptom-free exoforia, good sensorial binocular functions of normal type, sufficient although subnormal fusional amplitude and never exotropia. 8/25 patients are fair, that is only occasionally momentary occurrence of exotropia and binocular complaints. 4/25 patients are orthoptically poor (suppression on all tests), but without complaints. Eye position is on a whole unchanged for distance, whereas exodeviation has increased about 10 PD for near during the 10 years post-operative observation time (no orthoptic treatment in this period). 22/25 patients indicated spontaneously at the follow-up examination that they considered their squint cured. None of the patients had cosmetic or functional restrictions in jobs or studies.
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PMID:Ten years follow-up of surgery for intermittent exotropia. 377 99

A 36-year-old male had been constantly wearing a patch to avoid diplopia since an operation on the right parietal area of the brain. Postsurgical visual field evaluation indicated a complete bilateral left hemianopia with macular splitting. The patient had a constant alternating comitant exotropia with no suppression. By terminating the patching, establishing the appropriate fixing eye, and applying relieving prisms, diplopia was removed. Once binocularity was thus established, it was found (over the course of 7 months) that binocular function was possible with diminishing amounts of prism power. During this 7-month period, measurements of the patient's heterophoria, motor fusion, and sensory fusion revealed that he adapted from his occlusion-induced exotropia toward an habitual heterophoria. Such vergence adaptation has been defined as orthophorization. The occurrence of vergence adaptation after sensory fusion indicates that sensory fusion plays an important role in the etiology of prism adaptation.
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PMID:Orthophorization after occlusion-induced exotropia. 377 26

In two girls, 26 and 36 months old, strabismus and blepharoptosis secondary to myasthenia gravis led to amblyopia. The initial symptoms in both patients were blepharoptosis and variable exotropia. Although the amblyopia was successfully treated in one patient, it persisted in the second despite therapy.
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PMID:Juvenile myasthenia gravis and amblyopia. 394 39

Fifty-three patients with esotropia of 14 to 20 prism diopters received a 6-mm recession of one medial rectus muscle. All patients were three to ten years of age, had normal, equal vision, no vertical muscle imbalance, normal neurological status, and were followed for a minimum of two years. Twenty patients had high AC/A ratios, 22 were partially accommodative, four were deteriorated esophorias, four were anisometropes, and three were second operations. The average correction measured 16 prism diopters, ranging from 13 to 22 prism diopters, and 37 patients were aligned to 4 prism diopters or less of strabismus, 10 were microtropes, and all 53 had less than 10 prism diopters deviation. No persistent diplopia or consecutive exotropia was encountered. Stereopsis of 200 seconds or better was found in 75% of patients postoperatively. Large single medial rectus recessions appear to be a safe, effective, and predictable means of restoring ocular alignment and binocular vision in a select group of patients.
J Pediatr Ophthalmol Strabismus
PMID:Results of large single medial rectus recession. 395 Aug 37

Charts of all infantile esotropes who received their primary surgical procedure at the North Carolina Memorial Hospital, between February 1978 and June 1984 were reviewed. Neurologic problems (general and ocular) were identified in 29 of the 47 patients (61.7%) followed a minimum three months (mean = 25.0 +/- 2.9 mos). Frequent general neurologic problems were prematurity, hydrocephalus, mental retardation, cerebral palsy, meningomyelocele, intraventricular hemorrhage, and seizures (neonatal and/or postnatal). Abducens nerve palsy was the most common ocular neurologic impairment. Neurologic impaired esotropes were older (mean = 31.9 +/- 3.8 mos) than the "normal" group (mean = 17.0 +/- 3.3 mos) at the time of surgery. Recession/resection procedures were performed on 13 (44.8%) of the neurologically impaired and nine (50.0%) of the normal esotropes. Bimedial recessions were employed on 12 (41.4%) of the patients with neurologic problems and seven (38.8%) of the normal esotropes. Unilateral medial recessions and/or inferior oblique recessions were performed on six patients. At last follow-up, orthophoria (+/- 10 delta) was present in 16 (55.2%) neurologically impaired patients and 15 (83.3%) normal esotropes (p less than 0.05 by the normal deviate (z) test). Seven (24.1%) neurologically impaired patients had residual esotropia, while consecutive exotropia was present in six (20.7%) patients. Among normal esotropes, residual esotropia was found in one patient and consecutive exotropia in two (11.1%) patients. DVD's occurred in nine patients while four subjects developed a postoperative accommodative component.
J Pediatr Ophthalmol Strabismus
PMID:Infantile esotropia: results in the neurologic impaired and "normal" child at NCMH (six years). 395 Aug 44


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