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Hyeshin Jeon, Jaeho Jung, Heeyoung Choi
PURPOSE: To investigate the long-term outcomes of intermittent exotropia surgery for children less than 4 years of age. MATERIALS AND METHODS: Consecutive patients who underwent surgery for intermittent exotropia and had follow-up durations longer than 2 years were recruited. The patients were classified according to age at surgery-the patients of group 1 had undergone surgery before 4 years of age and those of group 2 at or after 4 years of age. Motor success was defined by exodeviation < 10 prism diopters (PD) and esodeviation < 5 PD at distance at 2 years postoperatively...
September 14, 2017: Current Eye Research
Kalpana Sharma, Praveen Panwar, Kulbhushan Prakash Chaudhary
Intermittent distance exotropia is a deviation characterized by an exophoria at near fixation and manifest exotropia at distance fixation. There is normal binocular fusional vergence and stereoacuity at near fixation, but the eyes tend to diverge in bright sunlight, tiredness, day dreaming and the patient may close one eye in such circumstances. Prematurity is associated with numerous eye pathology, besides retinopathy of prematurity, amblyopia, refractive errors, it is also associated with a higher risk esotropia and exotropia...
April 2017: Journal of Pediatric Neurosciences
Judy L Petrunak
BACKGROUND AND PURPOSE: Early onset exodeviations in systemically and ocularly healthy young children, diagnosed at less than 1 year of age, may be of the constant, "infantile XT" type, or early X(T) type. The onset of common childhood X(T) is not clearly known. The purpose of this lecture is to discuss theories and characteristics of early onset exodeviations, and report on our observations of infantile XT and early X(T) at Children's Eye Care in Michigan. PATIENTS AND METHODS: A retrospective review of 470 cases of childhood exodeviations (ages 6 months to 15 years) were reviewed and met inclusion criteria of no prior surgical treatment, no ocular, CNS or craniofacial disease, and no significant prematurity...
January 2017: American Orthoptic Journal
Steven D Maxfield, Sarah R Hatt, David A Leske, Jae Ho Jung, Jonathan M Holmes
PURPOSE: To evaluate the associations of clinical and surgical factors with atypical postoperative drift following surgery for consecutive exotropia. METHODS: A total of 66 patients with consecutive exotropia (≥10(Δ) at distance), after historical surgery for esotropia were retrospectively identified at a tertiary medical center. All patients underwent unilateral lateral rectus recession (on adjustable suture) with medial rectus advancement and/or resection. Immediate postoperative target angle was 4(Δ)-10(Δ) of esotropia at distance, anticipating mild postoperative exodrift...
August 31, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Alla A Vein
The sculpture of the devil on a portal of the Lichtenthal Abbey School in Baden-Baden, Germany displays neurological pathology, possibly consistent with multiple cranial neuropathy. One of the main abnormalities is an exotropia strabismus, a feature rarely depicted in works of art portraying the devil.
September 1, 2017: European Neurology
Smriti Bansal, Sima Das
Cyclic oculomotor nerve paresis and spasm are a rare disorder characterized by alternating spastic and paretic phase of the muscles supplied by the oculomotor nerve. A 26-year-old male presented with abnormal right eyelid movements since early childhood. Examination findings were consistent with diagnosis of right eye cyclic oculomotor nerve palsy. A paretic phase with complete upper eyelid ptosis, exotropia, hypotropia and dilatation of the pupil was followed by a phase of orthotropia, the absence of ptosis and normal pupil size...
July 2017: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
Ju-Yeun Lee, Ga-In Lee, Kyung-Ah Park, Sei Yeul Oh
PURPOSE: To evaluate the effect of initial postoperative deviation on subsequent reoperation in patients with intermittent exotropia and to compare the clinical factors and surgical outcomes between the two surgical failure groups. METHODS: The medical records of patients who underwent reoperation after failed primary surgery for intermittent exotropia at a single center were reviewed retrospectively. Patients with recurrent intermittent exotropia and consecutive esotropia were considered surgical failures...
August 28, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Tobias Torp-Pedersen, Heather A Boyd, Line Skotte, Birgitte Haargaard, Jan Wohlfahrt, Jonathan M Holmes, Mads Melbye
Importance: To our knowledge, there have been few population-based studies of strabismus incidence conducted. Our population-based study provides valuable data for health services planning and identifying research needs. Objective: To determine the incidence and age distribution of strabismus, overall and by subtype, among children 7 years or younger. Design, Setting, and Participants: This population-based cohort study was conducted with data from 96 842 children enrolled in the Danish National Birth Cohort...
August 31, 2017: JAMA Ophthalmology
I Sánchez-Guillén, R López, M A Calle, A B Diez-Lobo
OBJECTIVE: To analyze the analgesic effect of remifentanil, side effects and complications in topical strabismus surgery. To study the results of strabismus surgery with this type of anesthesia. MATERIAL AND METHOD: Retrospective descriptive study. We included 39 patients undergoing strabismus surgery with topical anesthesia and analgesia-based sedation with remifentanil. The data of the anesthetic and surgical technique, surgical results and stability of the deviation angle were analyzed...
August 19, 2017: Archivos de la Sociedad Española de Oftalmología
Michael C Brodsky
No abstract text is available yet for this article.
August 1, 2017: Investigative Ophthalmology & Visual Science
Daniel L Adams, John R Economides, Jonathan C Horton
Purpose: To determine if the deviation angle changes in subjects with intermittent exotropia as they alternate fixation between the right and left eye in primary gaze. Methods: In this prospective observational cohort study, 37 subjects with intermittent exotropia were tested for evidence of incomitance. The position of each eye was recorded with a video tracker during fixation on a small central target. A cover-uncover test was performed by occluding one eye with a shutter that passed infrared light, allowing continuous tracking of both eyes...
August 1, 2017: Investigative Ophthalmology & Visual Science
Zia Chaudhuri, Jibin John, Satinder Aneja, B K Thelma
PURPOSE: Familial clustering of common forms of primary strabismus like esotropia (ET) and exotropia (XT) is observed in a proportion of the strabismus cohort. The genetic components of this remain unidentified. Linkage studies have demonstrated susceptibility locus for primary strabismus at the STBMS1 locus on 7p22.1 as well as other loci on 4q28.3 and 7q31.2. Recently next generation sequencing (NGS) technology has emerged as a powerful tool in discovery genomics and a large number of novel disease-causing variants are being reported...
August 10, 2017: Strabismus
Pradeep Sharma, Shweta Chaurasia, Abhijit Rasal
A 16-year-old girl presented with left eye large-angle exotropia. On examination, we found bilateral limitation of adduction. CT orbit showed hypoplastic medial rectus bilaterally, but intraoperatively we found absent medial recti on both sides. This case report explains discrepancy between the imaging and the intraoperative findings and discusses the management dilemma in view of the risk of anterior segment ischaemia and how marked exodeviation and adduction limitation was tackled by the new technique of transposition myopexy, a modification of the procedure described by Nishida along with recession of lateral rectus to achieve good alignment...
August 9, 2017: BMJ Case Reports
Pukhraj Rishi, Ekta Rishi, Deepak Bhojwani
A 4-year-old girl presented with decreased vision since 3 months. Visual acuity was 20/20 in right eye and counting fingers at 2 meters in the left. Left eye examination revealed exotropia, retinal telangiectasia, extensive subretinal exudation over the macula and exudative retinal detachment suggestive of Coats' disease. Fundus fluoroscein angiography highlighted the hallmark 'light bulb' retinal telangiectasias, macular retinochoroidal anstamosis and peripheral nonperfused retina. The patient was treated with focal laser photocoagulation to the retinal telangiectatic vessels and scatter laser photocoagulation of the non-perfused retina...
May 2017: Oman Journal of Ophthalmology
Robyn M Rautenbach, Komala Pillay, Anthony D N Murray, Jeannine M Heckmann
We report the histopathological and ultrastructural tissue analysis of extraocular muscle (EOM) obtained from a patient with seronegative myasthenia gravis (MG) with treatment-resistant ophthalmoplegia for 3.5 years. The EOM demonstrated predominantly myopathic features and ultrastructural evidence of mitochondrial dysfunction, but the most striking features were increased endomysial collagen and adipocyte replacement of muscle fibers. By contrast, control EOM from a patient undergoing strabismus surgery for a sensory exotropia in a nonseeing eye and a similar duration of deviation, showed normal muscle histology...
July 24, 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Eunbi Kim, Dong Gyu Choi
BACKGROUND: To analyze the surgical outcomes for patients diagnosed with acquired nonaccommodative esotropia (ANAET). METHODS: In this retrospective study, the medical records of 35 patients who had undergone the surgery for ANAET with a postoperative follow-up period of 6 months or more were reviewed. The main outcome measures were postoperative esodeviation angle, final success rate, and factors affecting surgical outcome. Surgical success was considered to be an alignment within 8 prism diopters (PD) at distance and near...
July 24, 2017: BMC Ophthalmology
Shailja Tibrewal, Nishtha Singh, Marazul Islam Bhuiyan, Suma Ganesh
AIM: To study the factors affecting residual exotropia (>10 PD) at 4-6wk postoperative visit following two rectus muscle surgery for intermittent exotropia [bilateral lateral rectus (LR) recession or unilateral recess resect procedure]. METHODS: A retrospective chart review of patients with intermittent exotropia ≤50 PD who underwent two rectus muscle surgery in between Jan. 2011 to Dec. 2013 was performed. Possible factors were compared between patients with residual exotropia (>10 PD) and successful outcome (within 10 PD of orthotropia) at the 4-6wk postoperative visit...
2017: International Journal of Ophthalmology
Sylvia H Yoo, Lauren M Jansson, Hee-Jung Park
PURPOSE: To report the presentation and characteristics of strabismus in children with prenatal methadone exposure. METHODS: The medical records of children with prenatal methadone exposure were retrospectively reviewed. Those who were evaluated by pediatric ophthalmology were included. Information on the timing and types of prenatal exposure by trimester of pregnancy was then collected from the patients' mothers' charts. The children's perinatal histories and ophthalmologic findings were collected from their pediatric clinic charts and ophthalmology clinic charts, respectively...
July 12, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Seung Pil Bang, Soon Young Cho, Se Youp Lee
PURPOSE: To compare long-term surgical outcomes after bilateral lateral rectus recession (BLR) and unilateral lateral rectus recession-medial rectus resection (RR) for the treatment of basic-type intermittent exotropia. METHODS: Consecutive patients who underwent BLR or RR for treatment of intermittent exotropia between 1999 and 2010 and underwent ≥5 years of follow-up were recruited for this study. Surgical outcomes were grouped according to postoperative angle of deviation: overcorrection (esophoria/tropia >8 prism diopters [Δ]), success (esophoria/tropia ≤8Δ to exophoria/tropia ≤8Δ), and undercorrection/recurrence (exophoria/tropia >8Δ)...
August 2017: Korean Journal of Ophthalmology: KJO
Young Bok Lee, Dong Gyu Choi
BACKGROUND: The aim of this study was to compare the primary surgery and reoperation outcomes of unilateral lateral rectus recession and medial rectus resection (R&R) for intermittent exotropia. METHODS: We retrospectively reviewed the medical records of 80 patients, all of whom had undergone unilateral R&R for intermittent exotropia as a primary surgery or reoperation and been followed-up on postoperatively for 6 months or more. The patients were divided into two groups: unilateral R&R as primary surgery (group A, 44 patients) and unilateral R&R as reoperation (group B, 36 patients)...
July 5, 2017: BMC Ophthalmology
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