Beneficial Effect of Treatment for Strabismus in Patients with Bilaterally Poor Vision, Who Cannot See Their Strabismus

ABSTRACTMethods: Retrospective case note review of management of patients with bilaterally severely reduced vision presenting with symptomatic strabismus.Results: There were 10 females and 7 males, mean age at treatment was 36 years, range 19 to 74 years. Thirteen patients had an exotropia ranging from 20 to 90Δ (mean 52Δ). Four had an esotropia ranging from 30 to 70Δ (mean 53Δ). Vision in each eye ranged from 6/24 Snellen to light perception, except for one patient with Usher's syndrome who had grossly restricted visual fields and vision of 6/12 and 6/36. The etiology was retinitis pigmentosa in 5 patients; 3 had cone dystrophy, 2 were high myopes. Other etiologies included CMV retinitis in both eyes secondary to HIV, bilateral optic atrophy post craniopharyngioma, and cortical visual impairment. All patients were unable to see well enough to assess their strabismus but were aware of its presence from family members and friends and wished improvement. Eleven patients underwent botulinum toxin injections;...