Strabismus最新文献

{"title":"A study on the risk factors for the reoperation rate in strabismus surgeries in Eskisehir.","authors":"Safa Merve Icer, Mustafa Deger Bilgeç, Abdullah Divarcı, Yeliz Kılıç, Haluk Huseyin Gursoy","doi":"10.1080/09273972.2025.2561937","DOIUrl":"https://doi.org/10.1080/09273972.2025.2561937","url":null,"abstract":"<p><strong>Purpose: </strong>Reoperation may be necessary after strabismus surgery. Although different variables have been studied as predispoding to a reoperation, there is no consensus in this issue. In this study, in addition to previously studied parameters, it was aimed to investigate the effects of accommodative convergence/accommodation (AC/A) ratio, near convergence point (NPC), forced duction positivity and optical biometry on reoperation rates in strabismus surgery.</p><p><strong>Methods: </strong>Data of patients between 2010 and 2021 with minimum follow-up of 12 months were retrospectively reviewed. The study group (Group 1) included 77 patients who underwent surgery for strabismus for a second time, and the control group (Group 2) included 75 patients. Patients' surgical outcomes with a deviation of less than 10 prism diopters (PD) were defined as successful. Sex, family history of strabismus, presence of neurological comorbidities, follow-up time, spherical equivalent values, visual acuity, amblyopia, ocular rotations, preoperative and postoperative distance angles of deviation, asymmetric/symmetric surgery, diplopia, fixation preference, AC/A, NPC, stereopsis, forced duction test positivity and ocular biometry values were evaluated.</p><p><strong>Results: </strong>Asymmetric surgery, fixation preference, younger age at first surgery, shorter follow-up time, greater preoperative angle of deviation, a more distant NPC and greater lens thickness were found to be statistically significant predictors of reoperation (<i>p</i> < .05). There was no statistically significant difference in AC/A values (<i>p</i> = .92) and forced duction test positivity (<i>p</i> = 1) between the reoperation and control groups. Although amblyopia was more common in the reoperation group than in the control group, the difference was not statistically significant (<i>p</i> = .08).</p><p><strong>Conclusion: </strong>Asymmetric surgery, fixation preference, younger age at first surgery, shorter follow-up time, greater preoperative angle of deviation, a more distant NPC and greater lens thickness were found to be statistically significant for reoperation. In this study, convergence insufficiency was more frequent in the reoperation group. There may have been an increase in lens thickness to increase convergence in this group. Also, as optical biometric data changes with age, this may have affected the data results. Accordingly, it would be appropriate to investigate the parameters we studied with larger case series.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-observer reliability of the Harms tangent screen test.","authors":"Klemens Paul Kaiser, Thilo Demeter, Timo Drissler, Maria Fronius, Christoph Lwowski, Michael Müller, Thomas Kohnen, Jochen Triesch, Yaroslava Wenner","doi":"10.1080/09273972.2025.2570226","DOIUrl":"https://doi.org/10.1080/09273972.2025.2570226","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study is to evaluate the intra-observer reliability of the Harms Tangent Screen Test (HTS) for ocular motility analysis in eyes with diplopia due to concomitant, paralytic, or restrictive strabismus.</p><p><strong>Methods: </strong>This prospective clinical case study was conducted at the Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany. Squint angles were assessed subjectively in patients aged ≥18 years, presenting with diplopia due to concomitant, paralytic, or restrictive strabismus, using HTS across nine diagnostic gaze positions (0°; 25°). Repeatability was assessed by performing two consecutive measurements per patient by the same examiner. Measurement consistency was evaluated using the intraclass correlation coefficient (ICC) and the 95% limits of agreement (LOA).</p><p><strong>Results: </strong>A total of 58 patients (46.6% women) with a mean age of 54.0 ± 17.12 years were included. ICCs were highest for the horizontal squint angles of the nine gaze positions (≥0.99), followed by the vertical (0.96-0.99) and the torsional squint angles (0.93-0.98). Mean difference between the two measurements was ≤0.5° for the primary gaze position across all directions. LOA ranged from -3.1°; 2.9° (horizontal), -2.0°; 2.2° (vertical), and -3.6°; 3.1° (torsional). Maximum differences between the two measurements in the primary gaze position were ±8.0° (horizontal), ±5.0° (vertical), and ±6.0° (torsional).</p><p><strong>Conclusion: </strong>The HTS demonstrates good repeatability across all nine gaze positions in the horizontal, vertical, or torsional squint angles, indicating consistent measurement reliability regardless of gaze position.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Brown's syndrome following fourth nerve palsy - case series and review of literature.","authors":"Inès Schumacher, Pierre-François Kaeser, Nathalie Voide, Hilary Grabe, Mathias Abegg","doi":"10.1080/09273972.2025.2563047","DOIUrl":"https://doi.org/10.1080/09273972.2025.2563047","url":null,"abstract":"<p><p><i>Introduction</i>: Restriction of eye movements following fourth nerve palsy has been attributed to orbital injury in the past. In this report, we challenge this view. <i>Methods</i>: In a retrospective case series, we analyzed seven consecutive patients with a Brown's syndrome that evolved after a fourth nerve palsy. <i>Results</i>: All patients presented with fourth nerve palsies following trauma or meningioma surgery. After a delay of months, the fourth nerve palsy improved but the patients developed a limitation in adduction and upgaze in the same eye. None of the cases involved an injury to the orbit and the iatrogenic cases were secondary to neurosurgeries far from the orbit. A non-vascular fourth nerve palsy can evolve into a late onset motility limitation in the field of action of the antagonist in the absence of an orbital trauma. <i>Discussion</i>: We suspect an innervational mechanism as the cause of this secondary Brown's syndrome. This may involve aberrant-or compensatory innervation in different types of motoneurons innervating the superior oblique muscle.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into Straatsma syndrome: a pediatric case report.","authors":"Sara Ben Addou Idrissi, Hassan Moutei, Ahmed Bennis, Fouad Chraibi, Meriem Abdellaoui, Idriss Benatiya Andaloussi","doi":"10.1080/09273972.2025.2564760","DOIUrl":"https://doi.org/10.1080/09273972.2025.2564760","url":null,"abstract":"<p><strong>Introduction: </strong>Straatsma syndrome (SS) is a rare congenital entity defined by myelinated retinal nerve fibers (MRNF), amblyopia, and axial myopia, frequently with marked anisometropia and strabismus. Visual prognosis is often guarded, yet early multimodal management may modify outcomes.</p><p><strong>Methods: </strong>We report a pediatric right-eye SS with extensive, type-2 MRNF. At baseline the patient had alternating esotropia and high anisomyopia (cycloplegic refraction: RE -19.25/-2.50 × 005 D; LE -4.00/-3.00 × 165 D). Axial length measured 32.0 mm (RE) and 25.5 mm (LE). Optical coherence tomography (OCT) showed parafoveal retinal nerve fiber layer hyperreflectivity with foveal sparing. Management comprised full cycloplegic optical correction and structured occlusion/orthoptic therapy initiated at age 2, introduction of a scleral lens at age 7 to improve image quality and reduce aniseikonia, and strabismus surgery at age 10. Follow-up continued to age 13.</p><p><strong>Results: </strong>Despite severe amblyopia and anisometropia, best-corrected visual acuity (BCVA) in the affected eye improved from 0.7 to 0.1 logMAR by age 10 and was 0.0 logMAR at age 13, with stable primary-gaze alignment. The scleral lens was worn ≥8h/day and was well tolerated; it optimized retinal image quality and minimized spectacle-induced minification/aniseikonia associated with the high myopic correction.</p><p><strong>Discussion: </strong>This case illustrates that, even in the presence of type-2 MRNF, extreme axial length, and high anisometropia - features traditionally linked to poor prognosis - early aggressive amblyopia therapy, contact-lens - based aniseikonia control, and timely alignment surgery can achieve excellent long-term visual outcomes. The timeline underscores the importance of starting therapy in early childhood and maintaining adherence through optical optimization and orthoptics. While a single case cannot define generalizability, it supports the view that structural macular integrity on OCT, coupled with coordinated multimodal care, can overcome several adverse prognostic factors in SS.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-7"},"PeriodicalIF":0.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"History of strabismus management and treatment.","authors":"Tristan Jurkiewicz","doi":"10.1080/09273972.2025.2557250","DOIUrl":"https://doi.org/10.1080/09273972.2025.2557250","url":null,"abstract":"<p><strong>Background: </strong>Strabismus has been described since antiquity and was attributed to obscure phenomena or anatomical anomalies. The aim of this article is to examine the evolution of knowledge about strabismus and the treatments used to manage it over the centuries. This review helps us to understand how modern approaches emerged.</p><p><strong>Methods: </strong>A bibliographical study of the history of strabismus was carried out using the Gallica platform of the Bibliothèque nationale de France (BnF). This article is based on nearly a hundred books covering a period from 1598 to 1914.</p><p><strong>Results: </strong>During the Renaissance, knowledge about strabismus and its treatment primarily was based on texts authored by ancient medical practitioners. However, these approaches were largely ineffective due to limited understanding of the oculomotor system, for example with the face mask of Paul Aegineta. Strabismus in children was often attributed to factors like improper cradle positioning or imitation of affected individuals. Significant progress was made in the 18th century, leading to the development of the first treatment for amblyopia around 1750. This significant advance came from De Buffon, who suggested that strabismus resulted from a difference in the \"strength\" of the two eyes, and that covering the stronger eye would restore balance. Despite these improvements, controversies persisted about the causes of strabismus, its classifications, and the relationship with vision. By the early 19th century, detailed studies on the physiology of the eye muscles marked a turning point and paved the way for the first strabismus surgery. The procedure imagined by Dieffenbach gave initial promising results, but complications arose in many cases, such as the reappearance of strabismus or the appearance of a strabismus in the opposite direction. Later, the discovery of hyperopia and studies of binocular vision led to further advances in treatment and the development of rehabilitation methods.</p><p><strong>Conclusion: </strong>Collectively, these advancements transformed the understanding and management of strabismus, marking crucial milestones in the history of ophthalmology.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-14"},"PeriodicalIF":0.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marcus Gunn jaw winking associated with Duane's retraction syndrome.","authors":"Francesc March de Ribot, Anna March de Ribot, Josep Visa","doi":"10.1080/09273972.2025.2557260","DOIUrl":"https://doi.org/10.1080/09273972.2025.2557260","url":null,"abstract":"<p><p><i>Purpose</i>: We report a case of an unusual association between Duane retraction syndrome and Marcus Gunn jaw-winking syndrome in the eye of a patient without other anomalies.<i>Methods</i>: Clinical case. A four-year-old boy presented mild blepharoptosis of the left upper eyelid. The infant momentarily elevated the upper eyelid to a higher level by opening the mouth and thrusting the jaw to the right side. While attempting to abduct the left eye, there was no movement with the widening of the left palpebral fissure. Still, the normal movement of the right eye was consistent with the left rectus paralysis. Upon adduction of the left eye, the left palpebral aperture narrowed with retraction of the left eyeball.<i>Results</i>: The patient underwent an elevator resection on the affected side, achieving a satisfactory functional and cosmetic result. He has a normal life without concerns regarding his vision or appearance.<i>Conclusion</i>: We present a patient with DRS and MGJWS in the same eye. DRS has an absence of the abducens nerve and an aberrant innervation of the lateral rectus by branches originating from the inferior division of the oculomotor nerve. MGJWS presents connections of the trigeminal nerve to muscles of mastication and superior division of the oculomotor nerve controlling the levator palpebrae superioris. Embryologically, the motor branches of the trigeminal and oculomotor nuclei are close, explaining the possible abnormal connection. Some genes illustrate the absence of the abducens nerve and the overexpression of the trigeminal neurons, relating to both syndromes.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-4"},"PeriodicalIF":0.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence for hypermetropia, astigmatism, and anisometropia associated with, and early glasses preventing, the development of amblyopia and accommodative esotropia.","authors":"Jordy Sebastiaan Steltman, Sjoukje Elizabeth Loudon, Huibert Jan Simonsz","doi":"10.1080/09273972.2025.2551059","DOIUrl":"https://doi.org/10.1080/09273972.2025.2551059","url":null,"abstract":"<p><p>In many countries that have population-wide screening for amblyopia by measurement of visual acuity (VA), additional screening for refractive errors to prevent the development of amblyopia is being considered. We assessed the available evidence for the association between high refractive error in young children and the development of amblyopia and accommodative esotropia, and the influence of early prescription of glasses. The following search terms were used: refractive errors, amblyopia or strabismus, and children. Included were articles describing associations between high hypermetropia, astigmatism, anisometropia, and early glasses, and the development of amblyopia and accommodative esotropia. Longitudinal studies were included with children aged 6-24 months at entry, with retinoscopy in cycloplegia at least once and outcome assessed at age 3-9. Excluded were studies without a longitudinal design. In total, 5458 articles were identified. The authors of the relevant articles mainly originated from Kettering, Cambridge, Göteborg, and Columbus, Ohio, and additional studies by these research groups were added. Most studies did not determine the association, were not longitudinal, studied the accuracy of photoscreeners, the prevalence of refractive errors, or the effectiveness of screening programs. Therefore, 1 RCT, 2 controlled trials, and 13 observational cohort studies were included. For hypermetropia ≥+3.5D at 8-12 months, the odds ratio for developing amblyopia ranged between 17.09 and 141.67 (3 studies), for developing accommodative esotropia 16.13 and 22.51 (2 studies). For hypermetropia between >+2.66D and ≥+4D at 0-12 months increasing until age 3, the odds ratio for developing accommodative esotropia ranged between 5.33 and 195 (3 studies). For astigmatism ≥1.5D at 12 months, the odds ratio for developing amblyopia was 9.23 (1 study), for developing accommodative esotropia 1.42 (1 study). For astigmatism ≥1D at 12 months increasing until age 3, the odds ratio for developing amblyopia ranged between 10.13 and 141 (2 studies). For anisometropia ≥0.75D in combination with hypermetropia at 5-7 months, the odds ratio for developing accommodative esotropia was 1.31 (1 study). For early glasses at age 6-24 months, the odds ratio for developing amblyopia ranged between 0.10 and 0.79 (3 studies), for developing accommodative esotropia between 0.79 and 2 (5 studies). From our review, it seems that hypermetropia and astigmatism but not anisometropia correlate with the development of amblyopia and accommodative esotropia. The influence of early glasses seems moderate.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-16"},"PeriodicalIF":0.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes and etiological considerations in intermittent exotropia: a systematic narrative review.","authors":"Bernat Sunyer-Grau, Lluïsa Quevedo, Manuel Rodríguez-Vallejo, Marc Argilés","doi":"10.1080/09273972.2024.2449563","DOIUrl":"10.1080/09273972.2024.2449563","url":null,"abstract":"<p><p><i>Introduction</i>: Is Intermittent Exotropia being conceived and treated as an ocular-mechanical problem? Is etiology taken into account when planning for intervention? Which success criteria are used? Are they based on alignment or do they also consider visual function? In order to answer these questions, a review of studies assessing the outcomes of strabismus surgery in Intermittent Exotropia has been conducted. <i>Methods</i>: published between January 2003 and December 2023 were included. The database searched was MEDLINE following a predefined protocol. In addition to electronic database searches, manual searches were carried out and experts contacted. A total of 102 studies comprising 12 974 participants were included in this review. <i>Results</i>: Possible strabismus etiology was not stated in 91.2% of the studies. The underlying causes of the deviation were not taken into account for treatment consideration in any of the studies. Criteria for surgical success was based solely on ocular alignment (82.4%) and only 10 studies (9.8%) defined successful surgery with both motor and sensory criteria. Thirty-four different definitions of successful ocular alignment were identified. <i>Discussion</i>: In conclusion, Intermittent exotropia etiology is omitted in studies assessing surgical outcomes. The possible causes of the deviation are not taken into account when deciding on the type of surgery and are rarely mentioned. In most studies, the criteria for surgical success is based solely on eye alignment, independently of visual function and control.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"188-198"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is inferior oblique botulinum toxin injection an effective surgical simulator prior to inferior oblique myectomy? A 30-year retrospective review.","authors":"Christopher Norbury, Haider Shah, Ian Marsh","doi":"10.1080/09273972.2025.2452623","DOIUrl":"10.1080/09273972.2025.2452623","url":null,"abstract":"<p><p><i>Purpose</i>Botulinum toxin A (BTX) injected into the inferior oblique muscle temporarily simulates the post-operative effect of an inferior oblique myectomy (IOM). This can aid in surgical planning, especially given the irreversible nature of IOM. This study evaluates the efficacy of BTX as a pre-operative simulator and compares its effects to those of IOM. To our knowledge, this is the largest reported series of patients undergoing pre-operative BTX simulations, prior to IOM. <i>Methods</i>: A retrospective review was conducted on all patients receiving inferior oblique BTX between 1 January 1994 and 1 January 2024, by a single surgeon using an electromyography-guided technique. Data, including diagnosis, procedure, and orthoptic measurements, were obtained from electronic and archived paper records. Successful outcome was defined as subjective improvement in symptoms, or objectively as, reduction of vertical angle deviation in primary position by at least 50%, or post-procedure vertical deviation in primary position of ≤5 Prism Dioptres (PD). <i>Results</i>: Sixty-eight patients underwent inferior oblique BTX within the study period. Of these, 48/68 patients (71%) had an improvement in subjective symptoms. Subsequently, 36/48 patients (78%) underwent IOM, 4/48 (8%) patients are awaiting IOM, 4/48 (8%) patients requested repeat BTX despite IOM being offered, and 4/48 (8%) patients had complete resolution with no further intervention. Following IOM, 34/36 (94%) achieved the defined successful outcome, with no significant difference between vertical deviation measurements following BTX or IOM (<i>p</i> < .05). No post-operative diplopia or other complications were identified, and 3/36 (8%) patients demonstrated an asymptomatic over-correction. BTX was deemed unsuccessful in 20 patients (29%). Within this cohort, 12 had no improvement (despite repeat treatment with a higher dose), 3 patients were lost to follow-up, 1 patient died and 4 patients developed problematic diplopia in the primary position, which resolved when the BTX wore off. <i>Conclusions</i>: Inferior oblique BTX is a useful and reliable tool for IOM simulation, prior to irreversible surgery. Its temporary effect on vertical deviation in primary position is comparable to IOM, and can also be used as a tool to identify patients at risk of diplopia, or failure of treatment.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"166-173"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occlusion with high plus contact lenses in the treatment of strabismic amblyopia - a case series.","authors":"Ulrike Pichler, Lisa Gabriela Schneebauer, Verena Schoßleitner, Matthias Bolz, Anna Reisinger","doi":"10.1080/09273972.2024.2437411","DOIUrl":"10.1080/09273972.2024.2437411","url":null,"abstract":"<p><p><i>Introduction</i>: Amblyopia is a common disease, and interventions like patching treatment are well studied. When standard therapy fails, sometimes uncommon treatment options become necessary. <i>Methods</i>: We present three cases of patients with severe strabismic amblyopia with initial visual acuities of 20/400, 20/2000 and 20/160 who failed conventional treatment and subsequently received treatment with high-powered contact lenses (HPCL) of either + 22D or + 25D strength. <i>Results</i>: Visual acuity markedly improved in all three cases: 20/20, 20/50 and 20/25, respectively. <i>Conclusion</i>: While amblyopia treatment with HPCL will never be first-line therapy, our results are encouraging and show that this form of penalization should be considered if conventional therapy fails.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"204-207"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}