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Congenital Cranial Dysinnervation Disorder
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Infantile esotropia – Presence of large angle esotropia with an absence of abduction limitation on Doll's eye maneuver. Patching of either eye in a small child is usually helpful to observe full motility of horizontal extraocular muscles.
Etiology of accommodative esotropia — current concepts
Published in Jan-Tjeerd de Faber, 28th European Strabismological Association Meeting, 2020
Firstly, there are studies concerning binocular outcome in infantile esotropia, claiming that early surgically alignment is associated with better binocular outcome. However, this topic will not be discussed further in this paper.
Ophthalmology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Dissociated vertical deviation: a bilateral condition most commonly seen in association with infantile esotropia. At moments of inattention the eye will move up and then move down to its original position while the fixating eye remains still. It differs from inferior oblique overaction in that the eye may elevate in any position of gaze.
A Comparison of the Long-Term Surgical Outcomes of Horizontal Strabismus Surgery between Resident Clinic and Private Clinic Patients
Published in Seminars in Ophthalmology, 2022
Mohamad Dakroub, Dalia El Hadi, Ibrahim Hashim, Zeinab El Moussawi, Perla Ibrahim, Christiane Al-Haddad
Furthermore, we divided horizontal strabismus surgery into subtypes (esotropia vs exotropia). In our cohort, esotropia surgery could have been more challenging (with a lower success rate in the resident-performed surgeries) possibly due to a smaller surgical field in the nasal orbit. In contrast, in a previous study, success rate of strabismus surgery was lower when performed by residents-in-training on exotropic eyes, attributed to the use of adjustable sutures, a younger patient age and more amblyopia.14 Additionally, OPD patients had other ET diagnoses including sensory ET, CN VI palsy and Duane which tend to have higher postoperative recurrence rates with time and require further surgery. It is known that certain subtypes of strabismus have a higher success rate after surgical correction; one example is accommodative esotropia as compared to the congenital type. The success rate of accommodative esotropia surgery was reported at 86.4% in a study by Kushner.24 The existing literature reports a surgical success range for infantile esotropia between 83% and 94% in patients undergoing early surgery (by 6 months of age),25 and the value goes down to reach as low as 23% in patients with a large angle of deviation (≥55 PD).26,27 Congenital esotropia patients have up to 34% need for reoperation,28 with a large angle of deviation (above 30 PD) being a risk factor.28
Strabismus Repair in Children with Varying Severity of Cerebral Palsy
Published in Seminars in Ophthalmology, 2022
Roland Seif, Ghassan Hmaimess, Hoda Eid, Ibrahim Dunya
Full ophthalmic and orthoptic evaluations were conducted by the same examiner who is highly experienced in examining CP patients. Infantile esotropia or exotropia was defined as ocular misalignment prior to 6 months of age as known in the literature. Age-appropriate testing of best-corrected visual acuity (BCVA), pupil examination, ocular motility, alignment, and binocular fusion, in addition to a full manual cycloplegic retinoscopy, were performed on each patient and repeated on all follow-up examinations. A thorough retina examination was performed on all patients. BCVA was quantified using optotype (Snellen letter or Allen-type figures) testing when feasible or using visually evoked potentials. Stereopsis was performed using Stereo Fly or Randot preschool stereoacuity tests when feasible. A full orthoptic evaluation, including measurement of the angle of deviation for far and near, was performed by a specialized orthoptist. Measurement of the angle of deviation at near (33 cm) and far (6 m) using the alternate prism and cover test (when feasible) or the Hirschberg and Krimsky tests was conducted on all patients.
Outcomes of pediatric accommodative esotropia with botulinum toxin A treatment in Thailand
Published in Strabismus, 2021
Nutsuchar Wangtiraumnuay, Supawan Surukrattanaskul, Thamolwan Surakiatchanukul, Patcharapim Masaya-Anon, Juthathip Hiriotappa
Surgery is the current standard treatment for infantile esotropia and partially accommodative esotropia.15,16,17 Corrective lenses are the standard treatment for refractive and non-refractive accommodative esotropia. Here, we report our experiences with the botulinum toxin injection to the medial rectus as an optional treatment in accommodative esotropia with variable angles or poor compliance with glasses. With this blind technique injection without EMG, the resulting medial rectus weakening and complications started 3–5 days after the injection.