Strabismus最新文献

{"title":"Evaluation of the effectiveness of Cambridge Visual Stimulator treatment in amblyopia patients: a retrospective study.","authors":"Muhiddin Fatih Bodur, Esra Nur Saraç, Leyla Niyaz","doi":"10.1080/09273972.2025.2579178","DOIUrl":"10.1080/09273972.2025.2579178","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the long-term efficacy of the Cambridge Visual Stimulator (CAM) in pediatric amblyopia, by comparing outcomes of standard occlusion therapy alone versus occlusion combined with CAM.</p><p><strong>Methods: </strong>In this retrospective cohort, 112 patients (112 eyes) aged ≤10 years with strabismic or anisometropic amblyopia were assigned to one of two groups. Group 1 (<i>n</i> = 64) received three hours/day of occlusion therapy; Group 2 (<i>n</i> = 48) received the same occlusion regimen plus a supervised 5-day CAM course (six rotating high-contrast spatial-frequency disks, 18 minutes daily). Best-corrected visual acuity was recorded in logMAR at baseline, 6 months, and 12 months. Within-group improvements were analyzed using the Wilcoxon signed-rank test, and between-group differences with the Mann - Whitney U test. P-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Both groups showed significant acuity gains at 6 and 12 months versus baseline (<i>p</i> < .001 for all comparisons). Numerically, Group 2 improved more (6 months: -0.137 ± 0.231 vs. -0.127 ± 0.196; 12 months: -0.192 ± 0.267 vs. -0.190 ± 0.225), but these differences did not reach significance (6 months <i>p</i> = .402; 12 months <i>p</i> = .883).</p><p><strong>Conclusion: </strong>Occlusion therapy markedly enhances visual acuity in amblyopic children, whereas adjunctive CAM yields only limited additional benefit. Prospective, larger-scale trials are needed to determine whether specific subgroups - such as treatment-resistant cases - may derive clinically meaningful gains from CAM.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"184-191"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656392","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":"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":"227-233"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","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":"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":"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":"139-146"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","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":"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":"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":"125-132"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","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":"Refractive changes following congenital ptosis surgery.","authors":"Mohamad Watad, Moamen Masalha, Tamara Wygnanski-Jaffe, Oded Rock, Sharon Armanik, Mattan Arazi, Ofira Zloto","doi":"10.1080/09273972.2025.2575796","DOIUrl":"10.1080/09273972.2025.2575796","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate surgically induced refractive changes (SIRC) after congenital ptosis surgery. <i>Methods</i>: Data from 24 pediatric patients (age less than 18years old) who underwent congenital ptosis correction surgery between 2012 and 2020 and underwent cycloplegic refraction prior to and at least 3months postoperatively was retrieved from medical records at Sheba Medical Center. The Surgically induced refractive change (SIRC), marginal reflex distance-1 (MRD-1) after surgery were compared to before surgery.</p><p><strong>Results: </strong>Twenty-four patients were included in this study (16 boys and 8 girls) in a median age at the time of surgery of 1.82years. Eighteen patients underwent frontalis sling (FS), 3 levator resection (LR), 2 Müller's muscle-conjunctival resection (MMCR) and 1 LA (l levator advancement). MRD1 improved from 1.04 mm pre-operatively to 2.36 mm post-operatively (<i>p</i> < .001, paired samples t test). A significant surgically induced refractive change was found post-operatively in the operated eye and most patients were found to have more than 0.5D change in all examined parameters (sphere, cylinder, and spherical equivalent).</p><p><strong>Conclusions: </strong>Congenital ptosis surgery induces refractive change in most of the patients. Close follow up including frequent examination of cycloplegic refraction is required in order to determine the preferable timing of ptosis surgery and treatment following surgery.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"163-169"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769779","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":"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":"201-214"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","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":"Developing age-reference values for convergence and visual attention assessments.","authors":"Nicola Gavin, Lauren R Hepworth, Fiona J Rowe","doi":"10.1080/09273972.2025.2581092","DOIUrl":"10.1080/09273972.2025.2581092","url":null,"abstract":"<p><strong>Aim: </strong>Definitions and cutoff values for impaired near point of convergence, and for dominant/non-dominant hand completion of line bisection and cancellation tasks, in older adults are lacking. In this study, we investigate the measurements, response times, and accuracy in a non-clinical population with healthy eyes and cognition.</p><p><strong>Methods: </strong>This was a prospective cross-sectional study recruiting adults older than 50 years. Demographic data included hand dominance, sex, age, and ethnicity. The average of three near point of convergence measurements was recorded. Accuracy and speed of task completion were recorded for two-line bisection tasks (3 lines and 10 lines) and for the clock cancellation task, using dominant and non-dominant hands.</p><p><strong>Results: </strong>A total of 240 participants (161 female), with mean age of 61.23 years (SD8.71, range 50-97) were recruited. All participants had best corrected visual acuity of better than 0.1logMAR in each eye with no ocular pathology, and with no neurological disease. Overall mean near point of convergence was 9.22 cm (SD4.13), with slight decrease in convergence with increasing age (mean 11.71 cm in the 80th decade). Error cutoff for line bisection was determined as 6 mm with greater accuracy for the 10-line vs 3-line task. Error cutoff for the clock cancellation task was 42 with mean completion time of 1.5 minutes.</p><p><strong>Conclusions: </strong>We report normative ranges of older adults ( >50 years) to which future clinical comparisons can be made when evaluating near point of convergence and visual inattention. Further research is required in acquired brain injury populations to take into consideration any additional impact on task completion due to co-morbidities/associated sequelae of the brain injury.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"192-200"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453638","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":"Undercorrection of symptomatic esophoria after unilateral medial recession.","authors":"Mikael Hofsli, Tobias Torp-Pedersen, Jon Peiter Saunte, Claes Sepstrup Lønkvist, Steffen Hamann, Mark Alberti, Morten Dornonville de la Cour","doi":"10.1080/09273972.2025.2571769","DOIUrl":"10.1080/09273972.2025.2571769","url":null,"abstract":"<p><strong>Purpose: </strong>Symptomatic esophoria (SE) is a latent esodeviation that progresses into a manifest esotropia. Symptoms may include diplopia, headaches, and asthenopia. One muscle surgery is controversial due to concerns about undercorrections and/or the development of horizontal gaze incomitance. The aim of this retrospective observational study was to compare undercorrection rates in SE patients receiving standard orthoptic evaluation versus those supplemented with a prism adaptation test (PAT).</p><p><strong>Methods: </strong>We reviewed records of patients with SE who underwent unilateral medial recession (UMRc) surgery at the Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark, from 1 January 2017, to 31 August 2023. We collected information on whether PAT was conducted, demographics, and medical and ophthalmological history. Primary outcome was undercorrection after unilateral medial recession. Secondary outcomes included amount of lateral incomitance and changes in the angle of deviation following PAT.</p><p><strong>Results: </strong>Forty-one SE patients were included, with 29 in the non-PAT group and 12 in the PAT group. After adjusting for baseline deviation, the mean difference in deviation at near (AODn) and distance (AODd) was lower in the PAT group compared to the non-PAT group, respectively (<i>p</i> = .4 and <i>p</i> = .02). Mean adjusted AODd difference in ipsilateral and contralateral gaze to the side of UMRc was also lower in the PAT group compared to the non-PAT group, respectively (<i>p</i> < .001 and <i>p</i> = .009).</p><p><strong>Conclusion: </strong>SE patients who underwent PAT had lower residual deviation and were less prone to ipsilateral gaze incomitance on the side of the UMRc, compared with those who did not undergo PAT.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"147-153"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276582","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":"Early surgical excision for suture granuloma after strabismus surgery.","authors":"James R C Miller, Rohit Jolly, Saurabh Jain","doi":"10.1080/09273972.2025.2578265","DOIUrl":"10.1080/09273972.2025.2578265","url":null,"abstract":"<p><p><i>Purpose</i>: Suture granuloma is a recognized complication of strabismus surgery caused by a foreign body reaction to retained suture material. There is currently no standardized management strategy, although non-surgical treatments such as topical or oral steroids and beta blockers are commonly employed. However, treatment courses are often prolonged, and subsequent surgical excision may still be required. <i>Methods</i>: We describe the case of a nine-year-old female patient who developed large suture granulomas after uncomplicated right eyed lateral rectus recession and medial rectus resection surgery using 6/0 VICRYL. This occurred over the new insertion sites within three weeks despite sterile intraoperative techniques and good post-operative drop compliance. <i>Results</i>: There was no response to initial treatment with hourly dexamethasone 0.1% drops and oral ibuprofen, and repeat orthoptic assessment showed an early deterioration in post-operative control of the deviation. The patient was taken back to theatre for early revision surgery and found to have extensive granulation tissue overlying the retained suture fragments. The sutures and granulation tissue were completely excised, and there was subsequently good healing with no recurrence. A panel of expert opinion was surveyed to review current opinions in managing suture granuloma; this revealed a range of different practices, however very few respondents employed early excision. <i>Conclusion</i>: We suggest that prompt surgical intervention for suture granuloma can produce safe and effective results without the need for prolonged medical therapy and should be employed earlier in the management of severe cases following a short trial of intensive anti-inflammatory medications. Given the comparative rarity of suture granuloma it may be considered for monitoring, for example, by BOSU.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"243-246"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379826","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":"Primary concomitant horizontal strabismus as a clinical biomarker of severity in West Syndrome.","authors":"Siddharth Madan, Manisha Nagpal, Suvasini Sharma, Zia Chaudhuri","doi":"10.1080/09273972.2026.2672624","DOIUrl":"https://doi.org/10.1080/09273972.2026.2672624","url":null,"abstract":"<p><strong>Purpose: </strong>Ophthalmic associations of West syndrome, a rare clinical triad comprising infantile spasms, a pathognomonic electroencephalogram pattern of paroxysmal activity called hypsarrhythmia and global developmental delay, usually associated with neuro-radiological anomalies, have been sparsely reported. We observed primary concomitant horizontal strabismus, mostly exotropia, and palpebral aperture abnormalities, mostly epicanthal folds, in a large subset of these subjects presenting to our tertiary care pediatric hospital and pediatric ophthalmology services.</p><p><strong>Methods: </strong>This was a cross-sectional, observational, hospital-based study designed to descriptively record ophthalmic findings in children with West Syndrome with the aim to establish the array of ophthalmic associations of this condition. One hundred and eighteen consecutive subjects with the diagnosis of West syndrome, referred from the pediatric neurology division to the pediatric ophthalmology division, were recruited prospectively and evaluated comprehensively.</p><p><strong>Results: </strong>Primary concomitant horizontal strabismus (PCHS) was observed in 80/118 (67.79%) patients, exotropia in 58 and esotropia in 22 cases. Patients with PCHS had a significantly earlier age of onset as well as significantly increased number of drugs required to control the spasms as compared to the children without strabismus. 40/80 (50%) subjects of West Syndrome with PCHS demonstrated palpebral aperture anomalies, especially epicanthal folds, significantly more than subjects of WS without PCHS.</p><p><strong>Conclusions: </strong>PCHS along with eyelid and palpebral fissure anomalies are visible phenotypes and thus, very useful ophthalmological clinical biomarkers for early identification of children with increased severity of West Syndrome, which aids the pediatric neurologist toward early management of this life-threatening recalcitrant seizure disorder, while imaging and electro-encephalography evaluation is ongoing.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139690","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}