Strabismus

INTRODUCTION: Anterior segment ischemia (ASI) is a rare but potentially sight-threatening complication of strabismus surgery. Preoperative imaging of the iris vasculature may be appropriate in patients at high risk of ASI. In clinical practice, this is currently done through invasive fluoresceine or indocyanine green (ICG) angiography and in study context through laser speckle contrast imaging. The purpose of this study is to investigate the use of noninvasive optical coherence tomography angiography (OCTA) as a screening tool for ASI in strabismus surgery...

Introduction : The purpose of this study was to investigate near and distance visual acuity (VA) prior to, during and on completion of occlusion therapy for amblyopia. Method : Fifty-four patients aged 4-7 years (mean 4.9; ±0.44) with untreated strabismic, anisometropic or mixed amblyopia were recruited to the study following refractive adaptation where applicable. All patients underwent conventional occlusion (patching). Uniocular near and distance VA was tested using age and ability appropriate Crowded LogMAR VA tests prior to, during and upon conclusion of occlusion therapy...

PURPOSE/BACKGROUND: Visual acuity (VA) screening in children primarily detects low VA and amblyopia between 3 and 6 years of age. Photoscreening is a low-cost, lower-expertise alternative which can be carried out on younger children and looks instead for refractive amblyopia risk factors so that early glasses may prevent or mitigate the conditions. The long-term benefits and costs of providing many children with glasses in an attempt to avoid development of amblyopia for some of them needs clarification...

PURPOSE: There are limited tests of contrast sensitivity (CS) for use in children. The Hiding Heidi (HH) is suitable for all cognitive abilities, but has a ceiling effect. The Double Happy (DH) test has comparable thresholds to the Pelli Robson (PR), however the ability to detect changes in contrast has not been established. This study aims to compare contrast thresholds and agreement between HH and the DH, comparing to the PR chart in normal conditions and under reduced visual and lighting conditions...

A young male patient with unilateral pathological myopia complained of selective hypotropia for distance with exophoria. Due to large globe, a notable amount of inferior scleral show was evident. In this scenario, extensive dissection along inferior rectus muscle to perform a Faden procedure would have worsened the inferior scleral show. Thus, as an alternative, the anterior procedure, that is, "inferior rectus muscle Y-splitting procedure with 4-mm recession" was undertaken. At the end of 3 months follow up, the troublesome selective hypotropia for distance disappeared significantly with very little changes along the lower lid position...

Background : A clinician's choice of stereotest is influenced by the robustness of the measurement, in terms of sensitivity, specificity and test-retest variability. In relation to the latter aspect, there are limited data on the test-retest variability of these new tests and how they compare to the more commonly used stereotests. Therefore, the aim of the study was to determine the test-retest variability of four different measures of stereoacuity (TNO, Frisby, Lang Stereopad and Asteroid (Accurate STEReotest On a mobIle Device)) and to compare the stereoacuity measurements between the tests in an adult population...

PURPOSE: To compare the outcome of bupivacaine (BUP) injection vs mini-tenotomy of extra-ocular muscles in treating small angle horizontal strabismus in children. METHODS: A prospective comparative study that included a total of 40 patients. Twenty patients received 3 ml of 0.75% Bupivacaine (BUP) injection in both medial recti in case of exotropia and in both lateral recti in case of esotropia. MRI orbit was performed before and 30-60 days' post injection of bupivacaine to estimate changes in muscle size...

AIM: To comprehensively evaluate the efficacy and safety profile of tetracaine eye drops as a local anesthetic agent among pediatric patients undergoing for strabismus surgery. METHODS: We systemically searched four electronic databases (PubMed, Scopus, Web of Science, and Cochrane Library) from inception until April 2023. We included randomized controlled trials (RCTs) comparing tetracaine and placebo or no intervention for intraoperative and postoperative outcomes in strabismus surgery patients...

PURPOSE: To determine our rate of conjunctival cyst developing after strabismus surgery and to minimize its formation. MATERIALS AND METHODS: The data of 4026 eyes of 2662 patients were included in our retrospective analysis of, those that underwent strabismus surgery at the Beyoğlu Eye Training and Research Hospital Strabismus Unit between 2015 and 2021. Clinical characteristics and follow-up data of patients were recorded together with age, sex, and operation type...

Purpose: The aim of this study is to present six cases of pulled-in-two syndrome (PITS) in strabismus surgeries and to discuss our prevention and management strategies. Methods: This is a retrospective study presenting cases of PITS during strabismus operations. The medical records of the subjects who underwent operation in the strabismus unit of Beyoglu Eye Training and Research Hospital were reviewed retrospectively, from January 2000 till March 2022. Detailed ophthalmological examination records and angle of deviation were noted...

PURPOSE: For extra-large angle exotropia (>60 prism diopters, PD), single-setting surgical alternatives are scarce; frequently, more than two muscle or two eye procedures are indicated. To evaluate the viability of single eye surgery, a current randomized comparative trial is undertaken. METHODS: Twenty adult patients with extra-large angle exotropia underwent a thorough orthoptic evaluation before being divided into two groups at random. Ten patients in group 1 underwent medial rectus resection (5...

INTRODUCTION: Intermittent exotropia (IXT) is a common form of strabismus. It is an outward deviation of one eye typically when viewing at distance. Symptoms include, but are not limited to double vision, eyes feeling tired, excessive blinking, and reduced quality of life. Its clinical characteristics are distinctive from other types of strabismus. This paper provides a comprehensive review of prevalence, classification, risk factors, natural history and clinical characteristics of the divergence excess and basic exotropia types of IXT...

BACKGROUND: Postural control is a complex skill based on the collaboration of dynamic sensory mechanisms, namely the visual, vestibular, and somatosensory systems. METHODS: A literature survey regarding postural stability in strabismus and amblyopia was conducted using databases in order to collect data for a narrative review of published reports and available literature. RESULTS: The results of the literature survey were analyzed to provide an overview of the current knowledge of postural stability in strabismus and amblyopia...

BACKGROUND: The aim of this systematic review is to identify cases of neurogenic ocular palsy in the presence of COVID-19 and to document patient characteristics, type of palsy and possible aetiologies. METHODS: A systematic search of PubMed, Medline and CINAHL databases was conducted on the 6th of January 2023 to identify cases of neurogenic ocular palsy in patients with current or previous COVID-19 infection. Data were pooled to summarise the neurogenic palsy, patient clinical characteristics and proposed palsy mechanisms...

Purpose : Intermittent exotropia is a condition where divergent strabismus is present at certain times or fixation distances and is surgically treated with bilateral lateral rectus recession or unilateral lateral rectus recession with medial rectus resection. The main purpose of our study is to assess the relationship between the initial post-operative deviation and surgical outcomes in adult exotropes undergoing recess-resect surgery. Methods : A retrospective chart review was performed on adult patients who underwent unilateral recess-resect surgery for intermittent exotropia between March 2010 and February 2022 at a single institution with at least 3 months of follow-up...

PURPOSE: Approximately half of the children operated on for cataracts develop strabismus. We determined what factors predict its development. METHODS: In a retrospective, cross-sectional study, children who underwent cataract surgery before age 5 between 2010 and 2017 in a tertiary center in Brazil were identified from medical records. Subsequently, patients were invited for an ophthalmological examination to assess visual acuity, refraction, and strabismus (constant or intermittent heterotropy of any magnitude)...

PURPOSE: To study the surgical outcomes of consecutive exotropia and predictive factors, and to compare the medial rectus (MR) advancement, lateral rectus (LR) recession, or a combination of both procedures. METHODS: A retrospective study of patients diagnosed with consecutive exotropia that were operated on (2000-2020) were included. The convergence was classified from 0 to +++, with good: ++/+++ and poor: 0/+. A good outcome was considered when the final horizontal deviation was < 10 prism diopters (pd)...

To compare EEG-patterns after instillation of cyclopentolate versus placebo eye drops. Prospective, randomized, placebo-controlled, and observational pilot study is presented. Ophthalmology outpatient clinic Dutch metropolitan hospital. Healthy 6- to 15-year-old volunteers with normal or low BMI requiring a cycloplegic refraction/retinoscopy. Randomized; 1 visit 2 drops cyclopentolate-1% and 1 visit 2 drops placebo (saline-0.9%). Single-blind: conducting researcher. Double blind: subjects, parents, clinical-neurophysiology staff, neurologist, and statistician...

The gold standard of angle measurement is the prism alternating cover test (PCT). This method requires cooperation from the child, experience, and presents a significant inter-observer variability. Strabocheck® (SK) is a new simple tool for objective and semi-automated angle measurement. Our purpose is to evaluate Strabocheck® in children undergoing surgery for comitant horizontal strabismus. The study population was divided into 3 groups: infantile esotropia, partially accommodative esotropia and intermittent exotropia...

The aim of this study is to evaluate the effectiveness of an eccentric viewing training program that combines biofeedback training using micro-perimetry with home exercises on multiple visual function parameters and to explore potential relationships between post-treatment visual function parameters. A retrospective observational review of 27 participants who underwent the training program was performed. Eligible participants were diagnosed with bilateral central scotomas secondary to age-related macular degeneration...