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

The word "blockage" appeared the last ten years. It designs altogether a syndrom, a symptom and a pathogenic theory of squint. This term is analysed and discussed. The definitions, more or less precise, vary with the authors. The clinical signs attributed to the blockage are, in fact, due to the importance of the deviation. The electro-oculographic semeiology derives also partially of the magnitude of the angle of strabismus. The notion of a hypothetical nystagmus does not help for the understanding of the pathogenis of squint. The "faden operation", difficult and therefore dangerous in some hands, is perhaps an acquisition for the treatment of peculiar cases of nystagmus or paralysis. It would have been possible to expose the facts clearly by using only the terms of spasm and contracture. The confusion brought by the term of "blockage" is perhaps counterbalanced by the development of researches on the surgery of the arc of contact and on electro-oculography.
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PMID:[Is the term "blockage" just? (author's transl)]. 53 75

The cycloplegic effect of 1% Atropine Sulphate, 2% Homatropine Hydrobromide and 1% Cyclopentholate (Cyclolat) were compared on 8 to 10 year-old children with hyperopic accommodation and partial accommodation squint. The objective refraction was measured by skiascopy and with Hartinger's refractometer, and these two values were compared. The distant-vision correction, and also the near-vision correction needed so that Table 2 of Pursch's Tables could be read, were measured. Atropine showed itself to be the most effective cycloplegic agent. With atropine cycloplegia was attained in 46.77% - shown by a necessary near-correction of +2 dioptres, or less. In 27.42% the correction was +1.5 dioptres. With homatropine a correction of +2 dioptres or less occurred in 82.14%, after Cyclogyl in 72.34%. Better cycloplegia could be reached, if before the test correcting spectacles are worn. Only with repeated refraction-tests to overcome accommodation spasm could one succeed in finding the complete hypermetropic state -- even with the help of a not very demanding cycloplegic agent like atropine. Cyclogyl was found to be the most suitable agent here.
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PMID:[Cycloplegia and residual accommodation (author's transl)]. 124 85

In 99 patients undergoing strabismus surgery, an intravenous bolus of succinylcholine (Sch) was given after completion of the strabismus procedure. Reliable data were obtained in 53 patients. The interlimbal distance measured at 60 seconds after injection (VR60) was compared to the interlimbal distance at 1 and 6 weeks postoperatively, to evaluate the correlation between the drug-induced eye position under anesthesia and the awake-eye alignment postoperatively. Correlations were highest in patients undergoing symmetric recessions of the medial or lateral recti in primary horizontal strabismus. Confidence intervals of 0.8 to 1.2 were noted for both the esotropia and exotropia groups. Two patients experienced Sch-related complications of masseter spasm and prolonged apnea. Although infrequent, the potential gravity of the complications from Sch use and the currently enjoyed high rate of success in primary strabismus surgery suggest that these formulas not be used clinically. Nonetheless, the high correlations between the drug-induced and awake ocular position provide further support to the premise that the Sch sensitive fibers provide an important motor component to the awake eye position.
J Pediatr Ophthalmol Strabismus
PMID:Intraoperative succinylcholine and the postoperative eye alignment. 143 1

Thirty patients with blepharospasm, hemifacial spasm, strabismus and entropion were treated with botulinum A toxin giving satisfactory results. Rapid spasm relief, correction of strabismus and entropion were obtained. Only mild, transient and local side-effects occurred. The patients were followed up for 4-12 weeks with no recurrence. The clinical results show that local injection of a minute dose of botulinum A toxin in treating blepharospasm, hemifacial spasm, strabismus and entropion is a safe, effective and simple method of nonsurgical therapy.
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PMID:Treatment of blepharospasm, hemifacial spasm and strabismus with botulinum a toxin. 145 48

We analyzed patients treated during the past five years with botulinum toxin type A for strabismus and blepharospasm, reviewed our successes, failures, and unusual cases, and drew conclusions based on these treatments. Thirty-seven percent of the strabismus patients were cured, but many patients who were outside the strict definitions, still believed that they were significantly improved. A prominent feature in the treatment of strabismus was variability. Frequently, patients expected to do poorly had encouraging results. One permanent overcorrection occurred, and it converted an esotopic patient into an exotropic one with diplopia. This has persisted for 2.5 years and is the longest reported overcorrection to our knowledge. Our results indicate that larger doses of botulinum toxin produce longer spasm-free intervals in the treatment of blepharospasm. One patient receiving injections for her blepharospasm discovered that its cause was her sedative medication. This is the first reported case of a benzodiazepine inducing blepharospasm to our knowledge.
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PMID:A five-year analysis of botulinum toxin type A injections: some unusual features. 174 4

Botulinum A toxin has been used to treat strabismus and a variety of spasmodic neuromuscular diseases. Botulinum toxin treatment of strabismus is not as definitive and stable as the traditional surgical approach, but it has been found most useful in postoperative overcorrection, small deviations, sensory deviations, and acute sixth nerve palsy. This toxin has been effective in the treatment of essential blepharospasm and hemifacial spasm, for which it produces temporary relief of symptoms. In addition, this treatment has been applied to lower lid entropion, myokymia, aberrant regeneration of the seventh nerve, lid retraction, corneal exposure, nystagmus, spasmodic torticollis, and adductor spastic dysphonia.
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PMID:Botulinum A toxin (Oculinum) in ophthalmology. 192 43

Botulinum toxin therapy has emerged as a treatment modality for a variety of spastic- or contracture-related muscle diseases. Its safety has been proven for long-term use in the treatment of benign essential blepharospasm, hemifacial spasm, and certain types of strabismus. Recent approval from the Federal Drug Administration should make botulinum toxin available for use in a greater number of patients.
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PMID:Botulinum toxin therapy. 201 Nov 10

Botulinum A exotoxin was recently approved for use in Canada. We describe the efficacy of botulinum toxin in the management of 235 patients with blepharospasm (mean age 64.3 years) and 130 patients with hemifacial spasm (mean age 60.4 years) treated at three Canadian ophthalmologic centres between 1984 and 1989. A total of 98% of the patients with blepharospasm and 100% of the patients with hemifacial spasm had significant relief of their symptoms; however, 11% of the former and 2% of the latter did not respond to the usual starting concentrations of the drug and needed stronger dosages for relief. The duration of relief varied widely in both groups. Up to 7% of patients had ineffective treatments but responded to subsequent injections. Analysis of variance and linear trend statistics showed that there were no changes in the mean duration of relief over the first several treatments for individual patients in either group. Side effects were transient and included ptosis, exposure keratitis, epiphora and strabismus.
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PMID:Treatment of blepharospasm and hemifacial spasm with botulinum A toxin: a Canadian multicentre study. 205 23

The National Institutes of Health Consensus Development Conference on Clinical Use of Botulinum Toxin brought together neurologists, ophthalmologists, otolaryngologists, speech pathologists, and other health care professionals as well as the public to address: the mechanisms of action of botulinum toxin, the indications and contraindications for botulinum toxin treatment, the general principles of technique of injection and handling for its safe and effective use, and the short-term and long-term side effects and complications of therapy. Following 2 days of presentations by experts and discussion by the audience, a consensus panel weighed the evidence and prepared their consensus statement. Among their findings, the panel recommended that (1) botulinum toxin therapy is safe and effective for treating strabismus, blepharospasm, hemifacial spasm, adductor spasmodic dysphonia, jaw-closing oromandibular dystonia, and cervical dystonia; (2) botulinum toxin is not curative in chronic neurological disorders; (3) the safety of botulinum toxin therapy during pregnancy, breast feeding, and chronic use during childhood is unknown; (4) the long-term effects of chronic treatment with botulinum toxin remain unknown; and (5) botulinum toxin should be administered by committed interdisciplinary teams of physicians and related health care professionals with appropriate instrumentation. The full text of the consensus panel's statement follows.
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PMID:Botulinum toxin. 209 81

We report our experience with the use of Botulinum toxin injection in 38 patients (64 injections) with severe dysthyroid strabismus. Three quarters of the injections led to a decrease in the angle of the squint by a mean 75% of the initial deviation. The average duration of effect was two months. Twenty six patients went on to surgery after stabilisation of their squint and endocrine status. Six patients achieved a stable long-term result with Botulinum toxin only. We suggest these results of treatment of early dysthyroid myopathy are more consistent with the characteristics of inflammatory spasm than contracture. The value of Botulinum toxin as a temporary means of maintaining binocularity in these young patients is discussed.
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PMID:Botulinum toxin therapy in dysthyroid strabismus. 222 81


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