A retrospective survey of strabismus surgery in a tertiary eye center in northern China, 2014–2019
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Abstract Background To evaluate the distribution pattern and changes of strabismus surgery in northern China. Methods The records of strabismus patients at Qingdao Eye Hospital from January 2014 to December 2019 were reviewed retrospectively. The characteristics analyzed included gender, regional distribution, constituent ratio of age and type of strabismus. Changes during the periods 2014–2016 and 2017–2019 were compared and analyzed. Results A total of 5746 strabismus patients were recruited. The number of strabismus patients was relatively stable each year from 2014 to 2016 but gradually increased each year from 2017 to 2019. Of these, 51.7% (2968/5746) were male, and 48.3% (2778/5746) were female. The majority (89.8%, 5159/5746) of the patients were from Shandong Province. The statistical results of the constituent ratio of age showed that 32.4% (1860/5746) were 7–12 years old (primary school level). Patients under 12 years of age (preschool and primary school level) accounted for 60.0% (3447/5746) of all the patients. In terms of the types of strabismus, exotropia accounted for 63.5% (3650/5746), followed by esotropia and vertical rotational strabismus at 13.2% (758/5746) and 9.7% (555/5746), respectively. Intermittent exotropia was the most common type among the exotropia patients, accounting for 71.3% (2604/3650). Among the patients with intermittent exotropia, 62.5% (1627/2604) were children aged 4–12 years, and the basic type of intermittent exotropia was the main type. Four percent (231/5746) of the patients, of which adult patients comprised the main population, required reoperation. Conclusions Patients with strabismus at primary school level comprised the largest group of strabismus patients in north China. Exotropia was the most common type of strabismus, and intermittent exotropia was the most common type of exotropia. The rate of exotropia to esotropia was 5:1.Keywords:
Esotropia
Strabismus Surgery
Intermittent exotropia
Screening of 38,000 infants, age 1 to 2 1/2 years, showed a prevalence of 1.3% of strabismus and 0.5% of strabismic amblyopia. Esotropia was more than three times as frequent as exotropia. Approximately half of the cases with esotropia were amblyopic. Eighty-one percent of the cases with exotropia were intermittent, and in 29% the V-pattern was found. Significant ametropia was found in over 50% of the cases with strabismus. Although hypermetropia was the most frequent refraction in children with esotropia, myopia was a frequent finding in both esotropia and exotropia. Anisometroia was particularly frequent in constant unilateral esotropia. Accommodative strabismus was found in 7% of cases with infantile esotropia. In cases with paralytic strabismus, the most frequent muscle involved was the lateral rectus. Significant organic pathology, other than strabismus or amblyopia, was revealed in 0.2% of the series. "Rapid retinoscopy" through undilated pupils is an efficient method in detecting high refractive errors and candidates for nonstrabismic amblyopia in childhood. Since this method of examination is easy to perform, its adoption as a part of screening projects in childhood is recommended. "Rapid retinoscopy" performed by a trained orthoptist is also a useful method for detecting opacities in the ocular media.
Esotropia
Retinoscopy
Hypermetropia
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Objectives: Manifest strabismus in children is a major cause of suboptimum visual experience with attendant impact on their development. This study aims to determine the pattern of manifest strabismus among children attending the Paediatric Ophthalmology clinic of the University of Port Harcourt Teaching Hospital, Rivers State. Materials and method: One hundred and twenty-five (125) children, aged 6 months to 18 years with manifest strabismus were consecutively selected and examined out of one thousand eight hundred and ninety-seven (1897) children seen at the Paediatric ophthalmology clinic of the University of Port Harcourt Teaching Hospital over a period of 18 months. Severely ill children with manifest strabismus, children with phoria, pseudo-strabismus and microtropia were excluded. Results: There were sixty-nine females (55.2%) and 56 males (44.8%). The male to female ratio was 1: 1.2. The prevalence of manifest strabismus was 6.6%. Eighty-two (4.3%) children had esotropia, 38 (2.0%) had exotropia while 5 (0.27%) had vertical deviation. Infantile (congenital) esotropia 34 (27.2%) was the most common type of esotropia observed, followed by accommodative esotropia 13 (10.4%), while infantile (congenital) exotropia 19 (15.2%) was the predominant type of exotropia. Conclusion: The prevalence of Manifest strabismus among children attending the Paediatric Ophthalmology clinic is high. Esotropia was the commonest form of Manifest strabismus seen.
Esotropia
Port harcourt
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If homonymous hemianopia develops in childhood it is frequently accompanied by strabismus. In some of these cases the strabismus increases the size of the binocular visual field. We determined how prevalent visual-field-expanding strabismus is in children who have homonymous hemianopia. Medical records were examined from 103 hemianopic patients with exotropia (XT) or esotropia (ET). For each participant, we determined whether their strabismus was in a direction that resulted in visual field expansion (i.e. left exotropia with left homonymous hemianopia). Ages at which hemianopia and strabismus were first noted were compared to determine which developed first. The prevalence of XT (24%) and ET (9%) with homonymous hemianopia were both much higher than in the general population (1.5% and 5%, respectively). More strabismic eyes pointed to the blind than seeing side (62 vs 41, 60% vs. 40%, p = 0.02). Exotropic eyes were five times more likely to point to the blind side than esotropic eyes (85% vs 15%). Strabismus, especially exotropia, is much more common in pediatric homonymous hemianopia than in the general population. The strabismus is significantly more often in a visual field-expanding direction. These results support an adaptive role for the strabismus. Patients with HH and exotropia or esotropia should be aware that their visual field could be reduced by strabismus surgery.
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Esotropia
Hypertropia
Intermittent exotropia
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Purpose: To describe clinical characteristics of horizontal strabismus in Sudanese patients. Study Design: A retrospective chart review (RCR), a hospital-based study. Place and Duration of Study: Al-Neelain Eye Hospital, Khartoum, Sudan, from January 2017 to May 2021. Methods: There were 773 patients, who presented with horizontal strabismus. Data regarding demographics and eye examination including visual acuity, refractive error, and angle of deviation, type of strabismus (intermittent, constant, or alternating)were collected. Data analysis was done by SPSS 23, and statistical significance was set at P< 0.05. Results: The commonest strabismus was esotropia 522(71.5%). There were 415(56.8%) females. Most patients had alternating strabismus 436(59.7%), followed by constant strabismus 206(28.2%). Vision differed by types of strabismus (P =0.032) with worse vision found in esotropia(mean, 0.69±0.34)compared to exotropia (mean, 0.78±0.33). Refractive error varied by types of strabismus. Hyperopia was common with esotropia (mean, +3.9±3.8 D) and myopia was associated with exotropia (-3.4±2.8 D). The main cause of horizontal strabismus was congenital and presence of refractive error. Hyperopia was a major cause of esotropia for children aged 6 – 10 years which was highly significant (P <0.003) and myopia was the primary reason for exotropia at ˃15 years (P =0.485). Conclusion: The most common type of strabismus among Sudanese was esotropia. Causes of strabismus differed by age group with refractive error and congenital disorders accounting for most of the children aged less than six years and myopia for the majority of exotropia aged more than15 years.
Esotropia
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Purpose: The epicanthal fold in Korean children is a common cause of pseudoesotropia. Therefore, the present study was undertaken to evaluate the clinical characteristics of strabismus in children diagnosed with pseudoesotropia. Methods: We reviewed the charts of children diagnosed with strabismus from February 2004 to January 2005. Strabismic children with a history of pseudoesotropia were included in this study. We recorded the age and chief complaints at the time of pseudoesotropia diagnosis as well as the type of strabismus, the visual acuity, chief complaints, and refractive error at the time of strabismus diagnosis. Results: One hundred and two of 734 children with strabismus (13.9%) had a history of pseudoesotropia. The mean age at the time of pseudoesotropia diagnosis was 2.9 years. The mean age at the time of strabismus diagnosis was 4.4 years. The type of strabismus was exotropia in 58 (56.9%) and esotropia in 39 (38.2%) cases. Refractive accommodative esotropia was seen in 89.7% of esotropia cases and the basic type was seen in 86.2% of exotropia cases. The concurrence rate between chief complaints of pseudoesotropia and the type of strabismus diagnosed was lower in exotropia than in esotropia. There was hyperopia in all the esotropia cases, and the distribution of refractive error was variable in exotropia. The frequency of amblyopia was 19.6%. Conclusions: The incidence of strabismus is high in the case of children diagnosed with pseodoesotropia. Therefore, regular examinations for strabismus, refractive error and amblyopia may be necessary.
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Background Strabismus, also known as squint, is an ocular disorder in which the eyes do not align properly with each other when looking at an object. The estimated global prevalence of strabismus among children is between 1.3% and 5.7%. This study aimed to assess the various types of strabismus among pediatric patients in Jeddah, in the western region of Saudi Arabia. Methods The medical records of 281 patients with strabismus aged ≤18 years, who presented to the pediatric ophthalmology clinic in King Abdulaziz University Hospital between 2010 and 2019, were retrospectively reviewed. Data were analyzed using the Statistical Package for Social Sciences (SPSS; IBM Corp., Armonk, NY, USA). A p-value of 0.05 or less was considered statistically significant. Results Out of the 281 patients, 141 were (50.2%) female. The average age of the patients was 9.50 ± 4.24 years. The most common type of strabismus was esotropia (177 [63%] patients), followed by exotropia (96 [34.2%] patients), hypertropia (10 [3.6%] patients), and dissociated vertical deviation (four [1.4%] patients). Two-hundred thirty-one (82.8%) patients had bilateral strabismus. A total of 178 patients (63.3%) had no associated conditions with strabismus, whereas 103 (36.7%) had an associated condition. A significant relationship was observed between esotropia and prematurity (p = 0.024). Conclusion Esotropia was the most common type of strabismus among the patients, followed by exotropia. The results of this study showed that males were equally affected as females. We also found a significant relationship between esotropia and prematurity. Implementation of a compulsory nationwide pediatric ophthalmic screening program for children aged one, three, and five years is recommended to enable timely diagnosis of strabismus and any other refractive errors.
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Hypertropia
Medical record
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We undertook a retrospective study to evaluate strabismus surgeries done at the University Hospital and at the University Pediatric Hospital of the Puerto Rico Medical Center.The surgery schedules ranging from January 2003 to December 2007 were reviewed. Three types of strabismus were evaluated, including esotropia, exotropia, and hypertopia. Differences in the distribution of strabismus type according to age group and gender were assessed using the extension of the Fisher's exact test.A total of 120 patients were included (56 males and 64 females); the patients ranged in age from 4 months to 70 years (average: 15.1 years. Analysis of the distribution of strabismus type showed that 63 (52.5%) had esotropia; 49 (40.8%) had exotropia; 4 (3.3%) had hypertropia; 3 (2.5%) had both hypertropia and exotropia; and 1 (0.9%) had both hypertropia and esotropia. Both esotropia and exotropia were significantly (p < 0.0001) more common in children than they were in adults; however, hypertropia and combined strabismus types were more common in adults than they were in children. There was no statistical (p > 0.05) significance found upon analyzing strabismus distribution according to gender.Among patients with this eye disorder at the Puerto Rico Medical Center, the most common type of surgically treated strabismus was esotropia. Further studies will elucidate the prevalence of strabismus in Puerto Rico.
Hypertropia
Esotropia
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To investigate the correlation between strabismus and the severity of white matter damage of immaturity (WMDI), based on MRI findings. Although strabismus is commonly associated with WMDI, its clinical features are not well established.This cross-sectional study involved 73 consecutive patients who visited the department of ophthalmology and were diagnosed with WMDI. The severity of WMDI was graded based on the MRI findings of the patients. All of the patients underwent complete ophthalmic examination, and strabismus was characterised in terms of direction, constancy, and angle of deviation. The prevalence and the characteristics of strabismus and their correlation with the grade of WMDI were investigated.The perinatal characteristics, age at MRI, and the number of MRIs per child did not differ between different grades of WMDI. Refractive errors, found in 56 (76.7%) patients, did not differ between the grades of WMDI either. Strabismus was observed in 38 (52.1%) patients, and its prevalence increased with the grade of the disorder; 20 patients had exotropia and 18 had esotropia. Constant strabismus was found more frequently in patients with higher grade WMDI. However, the direction and angle of deviation did not differ depending on the grade of WMDI.The prevalence of strabismus increased with the severity of WMDI and was higher among patients with WMDI than among healthy individuals. The severity of WMDI might be related to the presence and constancy of strabismus.
Esotropia
Anisometropia
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Anatomical and neurophysiological studies suggest a relationship between "abnormal" visual pathways and strabismus found in the Siamese cat. A telephotographic method for measuring eye positions in these cats reveals that newborn Siamese cats have a conspicuous exotropia appearance. Adult animals appear to have esotropia, orthophoria, or exotropia, which can be intermittent.
Esotropia
Intermittent exotropia
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