Strabismus最新文献

{"title":"Divergence excess and basic exotropia types of intermittent exotropia: a major review. Part 1: prevalence, classification, risk factors, natural history and clinical characteristics.","authors":"Martin Ming-Leung Ma,&nbsp;Mitchell Scheiman","doi":"10.1080/09273972.2023.2227681","DOIUrl":"10.1080/09273972.2023.2227681","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>Search strategies involving combination of keywords including intermittent exotropia, exotropia, divergences excess, basic exotropia, prevalence, incidence, classification, terminology, risk factor, natural history, observation, angle of deviation, control, control score, symptom, quality of life, suppression, anomalous retinal correspondence, AC/A, accommodative convergence/accommodation, accommodative convergence, convergence, accommodation, vergence, incomitance and vertical were used in Medline. All English articles from 1900/01/01 to 2020/09/01 were reviewed. The reference list of the identified article was also checked for additional relevant article. Studies focused on animal model or strabismus associated with neurologic disorder or injury were excluded.</p><p><strong>Results: </strong>The estimated prevalence of IXT in children ranges from 0.1% to 3.7%. Hypoxia at birth and being female are potential risk factors of IXT. Using validated measures of control, multicenter prospective studies showed that the rate of conversion from IXT to constant exotropia is low. The angle of deviation is the most reported outcome measure in studies of IXT. It is often used to represent the severity of the condition and has been suggested as one of the four core outcomes for studies of the surgical management of IXT. Control of exodeviation is one of the four suggested core outcomes for study of surgery of IXT and is considered the main parameter of disease severity. Several validated tools for quality of life score are available to evaluate the subjective severity of IXT.</p><p><strong>Discussion: </strong>We reviewed the prevalence, classification, risk factors, natural history and clinical characteristics of the divergence excess and basic exotropia types of IXT. Further research into these areas, especially its clinical characteristics (e.g. suppression, dual retinal correspondence), will increase our understanding of this condition and potentially lead to better management of this common form of strabismus.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"97-128"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9866227","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":"COVID-19 and sudden-onset ocular neurogenic palsy in prior healthy patients: a systematic review.","authors":"Ryan Spiteri,&nbsp;Sousann Barakat,&nbsp;Meri Vukicevic","doi":"10.1080/09273972.2023.2232419","DOIUrl":"10.1080/09273972.2023.2232419","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>The combined database search yielded 1197 articles. Of these, 23 publications consisting of 25 patients met the inclusion criteria. Most patients were male (68%) and ranged in age from 2 to 71 years (median=32.7, SD=21.4). Seven patients (28%) were children aged 2 to 10 years old. Abducens palsies were most common (68%) and the most common ocular presentation was diplopia (76%) with an average time of onset 15 days from testing positive to COVID-19 or having symptoms of the virus. Proposed mechanism of development of a neurogenic palsy secondary to COVID-19 infection was classified into one of three categories: vascular/thrombotic, a viral neuro-invasive or inflammatory virus-mediated immune response.</p><p><strong>Discussion: </strong>This study suggests that COVID-19 infection may be linked to oculomotor, trochlear and abducens nerve palsies and the underlying mechanisms may vary but are difficult to definitively establish. Further studies investigating the onset of neurogenic palsy secondary to COVID-19 infection is required.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"145-151"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9766913","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":"Strabismus development after pediatric cataract surgery associated with age at surgery, intraocular lens implantation, and visual acuity outcome.","authors":"Celso Menezes Filho,&nbsp;Andre Messias,&nbsp;Rosalia Antunes-Foschini","doi":"10.1080/09273972.2023.2231038","DOIUrl":"10.1080/09273972.2023.2231038","url":null,"abstract":"<p><strong>Purpose: </strong>Approximately half of the children operated on for cataracts develop strabismus. We determined what factors predict its development.</p><p><strong>Methods: </strong>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). In addition, age at surgery, cataract laterality, intraocular lens implantation, surgical complications, nystagmus, anisometropia, and elapsed time between surgery and the present examination were assessed using logistic regression.</p><p><strong>Results: </strong>Surgery was performed in 74 eyes of 46 patients (21 males). The median age at surgery was 6.4 (3.7-29.6) months, and the interval between surgery and this examination was 32.5 (18.0-53.0) months. Strabismus was present in 33 (72%) patients, 35% had esotropia and 33% exotropia. One patient had strabismus surgery before the examination. Age at surgery (OR 0.95; <i>p</i>-value .018), IOL implantation (OR 0.08; <i>p</i>-value .027), and current visual acuity on the worse eye (OR 1.16; <i>p</i>-value .036) were associated with strabismus.</p><p><strong>Conclusions: </strong>Strabismus development after pediatric cataract surgery is associated with age at surgery, intraocular lens implantation, and visual-acuity outcomes of the worse eye.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"139-144"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9755146","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":"Using evidence-based psychological approaches to accommodation anomalies.","authors":"Anna M Horwood,&nbsp;Polly Waite","doi":"10.1080/09273972.2023.2171070","DOIUrl":"https://doi.org/10.1080/09273972.2023.2171070","url":null,"abstract":"<p><strong>Introduction: </strong>Accommodation anomalies are frequently caused or exacerbated by psychological problems such as anxiety. Patients share many features with those with other anxiety based somatic symptoms such as stomach-ache, palpitations and headaches. They can be difficult to treat, and the ophthalmic literature rarely goes beyond diagnosis and ocular treatment. This study reports characteristics and outcomes of a short case series of patients with accommodation spasms and weaknesses assessed objectively, and outlines a psychological approach to treatment.</p><p><strong>Methods: </strong>23 patients (13 severe accommodative weakness or \"paralysis,\" 10 accommodative spasm) aged between 8-30 years, were referred to our laboratory after diagnosis by their referring clinician and exclusion of pathology or drug-related causes. Their accommodation and convergence were assessed objectively with a laboratory photorefractive method, as well as by conventional orthoptic testing and dynamic retinoscopy. All interactions with the patients used an evidence-based psychological approach, to give them insight into how stress and anxiety can cause or exacerbate eye symptoms and help them to break a vicious cycle of anxiety and risk of deterioration.</p><p><strong>Results: </strong>83% were female and 57% had previously diagnosed anxiety or dyslexia (with many more acknowledging being \"worriers\"). Inconsistency of responses was the rule and all showed normal responses at some time during their visit. Responses were poorly related to the visual stimuli presented and objective responses often differed from subjective. Dissociation between convergence and accommodation was more common, compared to our large, previously reported, control groups. No participant had true paralysis of accommodation. Responses often improved dramatically within one session after discussion and explanation of the strong relationship between anxiety and accommodative anomalies. None have returned for further advice or treatment.</p><p><strong>Conclusions: </strong>Our approach explicitly addresses psychological factors in causing, or worsening, accommodation (and co-existing convergence) anomalies. Many of these patients do not realize that a certain amount of blur is normal in everyday life. Ocular symptoms are often a sign of anxiety, not the primary problem. By recognizing this, patients can be helped to address the triggering issues and symptoms often subside or resolve spontaneously. Well-meaning professionals, offering only ocular treatments, can deflect attention away from the real cause and can unwittingly be making things worse.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":"31 1","pages":"45-54"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9380890","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":"The impact of smartphone use on accommodative functions: pilot study.","authors":"Louise Allen,&nbsp;Jignasa Mehta","doi":"10.1080/09273972.2023.2179076","DOIUrl":"https://doi.org/10.1080/09273972.2023.2179076","url":null,"abstract":"<p><p>Evidence about the effect of smartphone use on accommodation is limited and inconclusive. Several studies have investigated either symptoms or near triad measures following smartphone use. These suggest that, certainly for the short term, smartphones have a negative impact on the near triad and produce symptoms. In addition, there is a body of recent work reporting cases of acute acquired concomitant esotropia (AACE) that may be caused by the accommodation-vergence demand of excessive smartphone use. A pilot study was undertaken to investigate accommodative measures before and after 30 minutes of smartphone use. Participants aged 16-40 years were invited to participate. Accommodative facility (AF), near point of accommodation (NPA), and near point of convergence (NPC) before and after 30 minutes of habitual smartphone use were assessed. NPA and AF were assessed with both eyes open (BEO), right eye (RE) and left eye (LE). Accommodative facility was assessed using ±2DS flipper lenses and measured in cycles per minute (cpm). NPA and NPC were assessed using the RAF rule and measured in centimeters. Data were analyzed in StatsDirect using non-parametric statistical tests. Eighteen participants were recruited, with a mean age of 24 years (SD: 7.6yrs). AF improved by 3cpm (<i>p</i>= .015) for BEO, 2.25cpm for RE (<i>p</i> = .004) and 1.5 cpm for the LE (<i>p</i> =. 278) after smartphone use. NPA with BEO became worse by 2 cm (<i>p</i> =.0474), with the RE worse by 0.5cms (<i>p</i> = .0474) and the LE, worse by 0.125 cms (<i>p</i> = .047). Convergence worsened by 0.75 cms (<i>p</i> = .018). Although these appeared to represent a change in measures following smartphone use, post-hoc analysis with Bonferroni correction demonstrated that these were not statistically significant at the 0.07 significance level. This pilot study found that there was no difference in accommodative and convergence measures before and after 30 minutes of smartphone use. These results suggest evidence contrary to the existing literature. There are several limitations to this pilot study and previous work, which are discussed. Suggestions on future work to explore the effect of smartphone use on the near triad to address limitations and further knowledge, in this area, are provided.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":"31 1","pages":"66-72"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9387248","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":"Strabismus and amblyopia in Africa - a systematic review and meta-analysis.","authors":"Prince Kwaku Akowuah,&nbsp;Samuel Adade,&nbsp;Andrews Nartey,&nbsp;Ebenezer Owusu,&nbsp;Richard Donkor,&nbsp;Stephen Ankamah-Lomotey,&nbsp;Asafo Agyei Frimpong,&nbsp;Joseph Adjei-Anang,&nbsp;Emmanuel Kobia-Acquah","doi":"10.1080/09273972.2022.2157023","DOIUrl":"https://doi.org/10.1080/09273972.2022.2157023","url":null,"abstract":"<p><p>The objective of this review was to estimate the prevalence of strabismus and amblyopia in Africa. A systematic online literature search was conducted for articles on strabismus and amblyopia in Africa. Meta-analysis was performed, using the Freeman-Tukey double arcsine transformation, to estimate the prevalence of strabismus and amblyopia in Africa. Subgroup analyses were conducted according to age, gender, study year, and type of amblyopia. Meta-regression was used to evaluate the influence of predetermined factors on the prevalence of amblyopia. 8 (1 population-based & 7 school-based) and 21 (3 population-based & 18 school-based) studies on strabismus and amblyopia with sample sizes of 22,355 and 46,841, respectively, were included in the review. Overall prevalence of strabismus in Africa was estimated to be 0.8% (95% CI: 0.4% - 1.4%); exotropia was 0.2% (95% CI: 0.1% - 0.5%) and esotropia was 0.5% (95% CI: 0.1% - 1.2%). Overall prevalence of amblyopia was estimated to be 0.6% (95% CI: 0.3% - 0.9%); refractive and strabismic amblyopia were 1.1% (95% CI: 0.2% - 2.5%) and 0.4% (95% CI: 0.2% - 0.6%), respectively. Prevalence estimate of amblyopia in males was 1.8% (95% CI: 0.7% - 3.3%) and in females was 1.3% (95% CI: 0.4% - 2.6%). There was a significant association between the prevalence of amblyopia and the type of amblyopia (p = .007) and the study year (p = .006). Although there appears to be a relatively low prevalence of strabismus and amblyopia in Africa, there is a dearth of well-designed population-based studies on strabismus and amblyopia in Africa, resulting in the lack of epidemiological information on strabismus and amblyopia within the general African population. Information about the prevalence of strabismus and amblyopia across Africa can inform policy making and design and implementation of public health intervention program.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":"31 1","pages":"31-44"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9374447","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":"Four cases of acute comitant esotropia associated with diffuse intrinsic pontine glioma in children.","authors":"D Osborne,&nbsp;J Richardson-May,&nbsp;K Bush,&nbsp;M Evans,&nbsp;S K West,&nbsp;K May,&nbsp;J Self","doi":"10.1080/09273972.2022.2143823","DOIUrl":"https://doi.org/10.1080/09273972.2022.2143823","url":null,"abstract":"<p><strong>Background: </strong>Acute acquired concomitant esotropia (AACE) is usually a benign form of strabismus that infrequently is associated with intracranial pathology. Clinicians have noted an increase in its incidence and theorize that it may be related to public health \"lockdown\" measures taken in response to the COVID-19 pandemic. With an increased incidence of AACE clinicians must firstly differentiate AACE from common accommodative esotropia and secondly recognize AACE as a possible sign of serious neuropathology.Diffuse Intrinsic Pontine Glioma (DIPG) is a devastating diagnosis for affected families. Children typically present at age 6-7 years with cranial nerve palsies, long tract signs, and/or cerebellar signs. Diagnosis is made from characteristic findings on magnetic resonance brain imaging (MRI brain) and treatment includes radiotherapy and palliative care. Two years from diagnosis, 90% of affected children will have died from their disease.</p><p><strong>Case series: </strong>We present four cases that attended our pediatric ophthalmology clinic with AACE either as a presenting sign of DIPG or as a clinical finding following a DIPG diagnosis. Patient A (age 5 years) presented to the emergency eye clinic with sudden onset diplopia and intermittent esotropia. Suppression later developed, they had 0.00 logMAR visual acuity either eye, and bilateral physiological hypermetropia. MRI brain imaging requested as a result of the unusual presentation led to the DIPG diagnosis. The other 3 cases (ages 11, 5 & 5 years) were assessed post DIPG diagnosis and found to have an esotropia measuring bigger on 1/3-meter fixation than 6-meter fixation, full ocular motility, physiological hypermetropia or emmetropia, and visual acuity normal for age. Other than patient B (age 11 years), who had papilledema and gaze evoked nystagmus when they were assessed 2 weeks prior to death, no patient had any other clinical eye findings.</p><p><strong>Conclusions: </strong>This small series of 4 patients attending our clinic within a 12-month period supports the notion that children presenting with AACE should routinely be offered brain MRI. Not all children with DIPG-associated AACE have significant ophthalmic findings indicative of intracranial pathology. With the potential for increased incidence of AACE related to lockdowns, clinicians should be reminded of the infrequent possibility their patient has a more serious condition.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":"31 1","pages":"26-30"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9374439","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":"Morphometry and anatomical variations of the inferior oblique muscle as relevant to the strabismus surgeries.","authors":"Tulika Gupta,&nbsp;Chetan Kharodi,&nbsp;Neelkamal Cheema","doi":"10.1080/09273972.2023.2168706","DOIUrl":"https://doi.org/10.1080/09273972.2023.2168706","url":null,"abstract":"<p><p>Effective outcome of inferior oblique (IO) corrective surgeries demands a detailed knowledge of morphometry and variations of IO. Our aim was to study and morphometrically define the surgical anatomy of the IO muscle and its variations. Also to provide easily identifiable surgical coordinates to locate, the IO origin and the oculomotor nerve entry point into the IO. Dissection was performed on 16 cadaveric orbits. IO anatomy, variations, morphometry and relevant surgical distances were measured using digital caliper. IO with multiple bellies was found in five specimens. The IO mean length was 33.1 ± 3.3 mm, width at origin was 3.1 ± 0.6 mm, and width at insertion was 8.8 ± 1.5 mm. For easy localization of origin, its distance from the palpable landmarks, Zygomatico-maxillary suture and fronto-maxillary suture was measured. The mean distance between IO and the optic nerve was 10 mm. Distance of the nerve to inferior oblique entry point to the origin and insertion of the inferior oblique was measured. The nerve to IO was 28 mm long. The mean distance of the nerve entry point to IO origin was 15.5 ± 2.3 mm and distance to IO insertion was 15.2 ± 2.8 mm. A muscular bridge between the Inferior rectus (IR) & IO was found in one case, affecting ~¼ of the IO length; the distal end of the bridge was 5 mm from the IO insertion. Origin of the IO can be localized on the orbital surface of maxilla, 1-2 cm from the point where zygomatico-maxillary suture cuts the inferior orbital margin and 1-2 cm from the fronto-maxillary suture. In 19% of the orbits, the IO length was less than 30 mm, which may cause traction injury in muscle transposition procedures. The width at insertion is useful as most corrective surgeries are performed at the insertion site. The nerve to IO consistently entered at the center of medial border. The nerve entry point is important surgically as myectomy is performed between it and the insertion point. The safe distance available from the optic nerve was 7 mm. Detailed morphometry of IO may aid surgeons in better surgical planning and execution.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":"31 1","pages":"17-25"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9382081","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":"Prism adaptation response and surgical outcomes of acquired nonaccommodative comitant esotropia.","authors":"Noriko Nishikawa,&nbsp;Yuriya Kawaguchi,&nbsp;Rui Fushitsu","doi":"10.1080/09273972.2022.2143824","DOIUrl":"https://doi.org/10.1080/09273972.2022.2143824","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical factors influencing the prism adaptation response of acquired non-accommodative comitant esotropia (ANAET) and evaluate the surgical outcomes.</p><p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>This study assessed patients with ANAET who underwent strabismus surgery based on the results of a short prism adaptation test (PAT). Patients wore Fresnel trial prisms based on alternate prism cover tests in outpatient clinics. The cover test was then performed after 15-20 minutes; if the deviation increased, the power of the prism was increased to neutralize the angle. The test was repeated until the angle was stable. Patients were classified as either prism builders (angle increased by ≥ 10 prism diopters [PD] compared with the entry angle) or prism non-builders (angle increased by < 10 PD). The following clinical characteristics were noted: age at onset, age at surgery, duration of esotropia, refractive error, angle of deviation, presence or absence of intermittent esotropia at near, and pre- and postoperative sensory status.</p><p><strong>Results: </strong>A total of 41 patients (median age, 15.4 years) were evaluated. The mean (standard deviation) spherical equivalent refractions were -3.03 (3.33) diopters (D) and -3.05 (3.23) D in the right and left eyes, respectively. Twenty-seven (66%) patients were prism builders. The prism builders had greater myopia (builders vs. non- builders, right eye: -3.97 [2.97] vs. -1.22 [3.33] D, P = .01; left eye: -4.08 [2.78] vs. -1.07 [3.20] D; P = .003), lower angle of deviation at near (median [interquartile range] 30.0 [20.0, 35.0] vs. 42.5 [35.0, 49.4] PD; P = .009), much more preoperative intermittent esotropia or esophoria at near (44% vs. 7%, P = .03) and diplopia (96% vs. 64%, P = .01), and better postoperative stereoacuity (50 [40, 110] vs. 100 [60, 400] arcsec, P = .02) than the prism non-builders. The overall success rate was 83%, without a significant difference between the two groups (builders vs. non-builders, 89% vs. 71%, P = .21).</p><p><strong>Conclusion: </strong>In cases of myopic refractive error, a small entry angle with intermittency at near, and good binocularity, it is recommended that surgery is performed based on prism-adapted angle to prevent under-correction.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":"31 1","pages":"9-16"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9373945","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":"Binocular contrast sensitivity in patients with intermittent exotropia in relation to angle of strabismus and level of compensation.","authors":"Fatemeh Moradi,&nbsp;Ali Mirzajani,&nbsp;Mohammad Reza Akbari,&nbsp;Masoud Khorrami-Nejad,&nbsp;Jamileh Abolghasemi,&nbsp;Babak Masoomian","doi":"10.1080/09273972.2022.2141272","DOIUrl":"https://doi.org/10.1080/09273972.2022.2141272","url":null,"abstract":"<p><p>Intermittent exotropia (IXT) causes photophobia, and photophobia has been studied by measurement of contrast sensitivity (CS). CS was reduced in children with IXT. We compared binocular CS (BCS) in patients with IXT and normal subjects in relation to the angle of strabismus and control of IXT. This case-control study was performed on 40 patients with IXT and 40 normal subjects who were examined with the CSV1000 CS device in mesopic (3 cd/m2) and photopic (85 cd/m2) conditions with and without a glare stimulus at 3, 6, 12, and 18 cycle/degree (cpd) spatial frequencies. The angle of strabismus and near stereoacuity were also measured. The patient's IXT compensation was graded based on the office control scale. The mean age for IXT and normal participants were 12.30 ± 0.60 (range, 6-18) and 11.00 ± 0.78 (range, 6-18) years, respectively (<i>P</i> = .34). The IXT patients had lower binocular CS than controls at all spatial frequencies (<i>P</i> < .001). The largest decrease in CS occurred at 6 cpd spatial frequency under mesopic condition (1.61 ± 0.07 vs 1.38 ± 0.15, <i>P</i> < .001) and photopic condition with glare (2.03 ± 0.06 vs 1.77 ± 0.13, <i>P</i> < .001). Patients with better control scores had higher levels of BCS; also, the score of BCS showed a significant decrease in patients with a deviation of 25 prism diopter or more, compared to those with less deviation. BCS correlated at 3 and 6 cpd with near stereoacuity (r = -0.652, <i>P</i> < .001 and r = -0.613, <i>P</i> < .001). Binocular CS in patients with IXT correlates with the angle of strabismus and level of compensation.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":"31 1","pages":"1-8"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9380758","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}