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

Congenital esotropia represents the most common type of strabismus. Its pathogenesis, however, remains uncertain. It is typically characterized as a large angle, constant esotropia with onset during the first six months of life. Associated clinical findings include normal refractive errors for age, amblyopia, dissociated vertical deviation, inferior oblique muscle overaction and nystagmus. It must be distinguished from Duane's retraction syndrome, Moebius syndrome, nystagmus blockage syndrome, and early onset accommodative esotropia, as well as other causes of esotropia in infancy. The surgical management may involve recession of both medial recti muscles, unilateral recession of a medial rectus muscle and a resection of a lateral rectus muscle or three or four muscle surgery.
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PMID:Congenital esotropia. 330 94

Essential infantile esotropia is an early acquired, not a congenital, condition, although congenital factors may favor its development between the ages of 3 and 6 months. It must be distinguished from other forms of esotropia with an onset between birth and the first six months of life. The cause of essential infantile esotropia remains unknown, but advances in our knowledge can be expected from the rapidly emerging discipline of infant psychophysics. In analyzing treatment results, a clear distinction must be made between normal, subnormal, and anomalous forms of binocular cooperation. While complete restoration of normal binocular function is rarely, if ever, achieved, anomalous binocular cooperation has many functional advantages over suppression or diplopia and should not be disturbed by overzealous treatment. Subnormal binocular vision is considered to be an optimal, microtropia a desirable, and a residual small angle heterotropia an acceptable end stage of surgical therapy. In a study of 358 surgically treated patients with a documented onset of essential infantile esotropia before age 6 months, subnormal binocular vision was present in 71 (20%), a microtropia in 25 (7%), and a small angle esotropia or exotropia in 140 (39%) of the patients. Surgical alignment before completion of the second year of life improved the chances for an optimal treatment result.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A reassessment of infantile esotropia. XLIV Edward Jackson memorial lecture. 333 86

The prevalence of primary monofixation syndrome (MFS) in the general population is approximately 1%. This study was performed to determine the prevalence of primary monofixation in biological parents of children with congenital esotropia. Ninety children with congenital esotropia were seen between November 1991 and June 1992 by one ophthalmologist (M.M.P.). One hundred and twenty-nine biological parents of these children were screened for sensorimotor abnormalities. Twelve parents were found to have secondary MFS and were removed from the analysis. This left 78 apparently non-strabismic families consisting of a total of 117 parents. Seven parents were identified as having primary MFS. The prevalence of primary MFS in this population is 9% of families and 6% of parents. Congenital esotropia is believed to be inherited in a multifactorial fashion. We believe that this increase in the prevalence of primary MFS compared to the general population lends support to the hypothesis that primary MFS may be a mild (subthreshold) effect of the "gene(s)" that cause congenital esotropia.
J Pediatr Ophthalmol Strabismus
PMID:Prevalence of primary monofixation syndrome in parents of children with congenital esotropia. 783 16

Congenital esotropia is a common type of strabismus that occurs shortly after birth, though the ophthalmologist is seldom consulted at an early date. We conducted a retrospective study of 7 children of congenital esotropia who were diagnosed before the age of 6 months and underwent bilateral medial recti recession (6-7 mm) when 1.5 to 3 years old. Postoperatively, 5 patients attained normal ocular alignment (< 10 prism diopters), and 2 were undercorrected to need a second operation. The differential diagnosis and treatment of congenital esotropia were discussed.
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PMID:[Congenital esotropia]. 816 92

Congenital esotropia develops in the first 4 months of life in an infant who lacks the inborn mechanism for motor fusion. It manifests as an esotropia which is not eliminated by correction of hyperopia and occurs in an otherwise neurologically normal infant. The earliest practical time for surgery is 4 months of age. The eye is anatomically suited for surgery at this age and also, this is the earliest age that congenital esotropia can be diagnosed with confidence. The best attainable result of treatment of congenital esotropia is subnormal binocular vision. This result is more likely to be attained if infants are aligned by 18 months of age. Satisfactory alignment is produced in 80% to 85% of infants in one procedure with an appropriate bimedial rectus recession. An array of motor defects including DVD, latent nystagmus, oblique dysfunction, and A- and V-pattern appear at varying times after successful alignment. These associated findings are commonly found with, but are not unique to, congenital esotropia. The onset and clinical picture of congenital esotropia is satisfactorily explained by a theory first suggested by Worth that the strabismus is caused by an inborn defect in the motor fusion mechanism and aggravated by esotropital factors as suggested by Chavasse. In contrast to congenital esotropia, all other strabismus can be thought of as occurring on a secondary basis in a person with the inborn capacity for motor fusion, but who failed to maintain it because of conatal insurmountable strabismus (congenital third nerve palsy), who lost it because of acquired (postnatal) strabismus, who uses a strategy such as head posture alteration to retain fusion under favorable circumstances (Duane syndrome), who has intermittent strabismus with part-time suppression (X(T)), or who is maintaining alignment with nonsurgical means (refractive esotropia). For the future, I believe that advances in the management of congenital esotropia will depend on a better understanding of etiology leading to design and use of innovative nonsurgical techniques to discourage convergence and stimulate bifoveal fusion.
J Pediatr Ophthalmol Strabismus
PMID:19th annual Frank Costenbader Lecture--the origins of congenital esotropia. 771 8

This review reports on articles written on comitant strabismus during the past year. Congenital esotropia was a recurring theme in these publications. Included in this review are articles that provide an insight into the basis for motor epiphenomena such as optokinetic nystagmus asymmetry and latent nystagmus. The optimum window of opportunity to achieve quality binocular vision by surgical alignment in congenital esotropia is discussed. We also report on articles that address various aspects of the management of comitant strabismus including the amount of medial rectus recession for esotropia, the target angle for best results in accommodative esotropia with high accommodation convergence/accommodation ratio, and issues related to comitant exotropia.
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PMID:Comitant strabismus. 1015 14

Congenital esotropia is defined as an esotropia before the age of 6 months, because of its early onset and often constant angle, it cause heavier binocular visual function damage compared with other types of strabismus. Early surgery can improve binocular visual function, but demand reliable, accurate measurements which is difficult to achieve in children, and it may increase the risk of second surgery, amblyopia and anesthesia. Late surgery can gain reliable strabismus angle, but it reduced the likelihood of recovery binocular visual function, and the contracture of medial rectus after a long time esotropia increased mechanical limitation of adduction. Therefore, the choice of timing to do surgery has been controversy over the years. In this paper, we will combine the research status and clinical practice to discuss this issue, and present some point of view for the peer reference.
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PMID:[Timing of surgery for congenital esotropia]. 2425 52