Eye
A. Sahib El-Radhi in Paediatric Symptom and Sign Sorter, 2019
Strabismus – misalignment of the eyes – is a common ophthalmic problem, affecting 4%–5% of children younger than 6 years of age (Figure 9.2). It is associated with a significant negative impact on quality of life. Early detection and repair prevent visual and psychosocial dysfunction. Strabismus is diagnosed clinically, which involves examination of the corneal light reflex and cover test. It may be transient or constant, and manifest or latent. Because of different causes and treatments, it is important to divide strabismus into non-paralytic and paralytic. Non-paralytic strabismus includes inward deviation of the eyes (esophorias, commonly known as convergent or inward or crossed eyes), outward deviation of the eyes (known as exophorias, or divergent strabismus) and hyperdeviation (upward) and hypodeviation (downward) of an eye. Paralytic strabismus involves palsy of the third, fourth or sixth cranial nerve. Strabismus may be a congenital (or better termed infantile, as this allows inclusion of cases of strabismus that develop within the first few months of life) or an acquired form. One of the most important and serious causes of the acquired form of strabismus is retinoblastoma.
Eye
A Sahib El-Radhi, James Carroll in Paediatric Symptom Sorter, 2017
Strabismus, misalignment of the eyes, is a common ophthalmic problem, affecting 4%–5% of children younger than 6 years of age. Strabismus is diagnosed clinically, which involves examination of the corneal light reflex and cover test. It may be transient or constant, manifest or latent. Because of different causes and treatments, it is important to divide strabismus into non-paralytic and paralytic. Non-paralytic strabismus includes inward deviation of the eyes (esophorias, commonly known as convergent or inward or crossed eyes), outward deviation of the eyes (known as exophorias, or divergent strabismus) and hyperdeviation (upward) and hypodeviation (downward) deviation of an eye. Paralytic strabismus involves palsy of the third, fourth or sixth cranial nerve. Strabismus may be congenital (or better termed ‘infantile’, as this allows inclusion of cases of strabismus that develop within the first few months of life) or acquired form. Of the most important and serious causes of the acquired form of strabismus is retinoblastoma.
An Approach to Oculomotor Anomalies in a Child
Vivek Lal in A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Infantile esotropia is a comitant, constant, non-accommodative esotropia that typically begins before the age of 6 months (Figure 21B.1). The angle of esotropia is generally large and amblyopia is not common. In cases of suspected infantile esotropia, it is important to evaluate for frequently associated signs such as dissociated vertical deviation, over-elevation in adduction, latent nystagmus, and optokinetic asymmetry. In addition, one must be sure that abduction is full in each eye, and this may require testing monocularly to avoid cross-fixation. A complete eye examination is essential to rule out other etiologies of infantile-onset esotropia such as Duane syndrome, Mobius syndrome, myasthenia gravis, early-onset accommodative esotropia, nystagmus blockage syndrome, or other neurological diseases. In addition, early-onset sensory strabismus due to poor vision in one or both eyes may present with an esotropic deviation (although sensory exotropia is more common). In cases of typical infantile esotropia, no neuroimaging is required.
Ultrastructural changes of extraocular muscles in strabismus patients
Published in Ultrastructural Pathology, 2019
Yahya Al-Falki, Mubarak Al-Shraim, Nasser A. Alsabaani, Refaat A. Eid, Khaled Radad
Strabismus is an inability to keep eyes alignment on the object which is the target of fixation.1 It is a very common ocular problem found at clinics of optometry and ophthalmology with a worldwide prevalence ranges from 2% to 5%.2,3 The prevalence between genders is equal.4 Strabismus can be intermittent or constant, unilateral or bilateral and when the eye is misaligned inward, outward, upward and downward, it is called esotropia, exotropia, hypertropia and hypotropia, respectively.5 Esotropia is among the most common form that constitutes a half to two-thirds of all misaligned eyes.3 Besides cosmetic issues, strabismus can result in vision loss and impaired binocular function.6 Moreover, strabismus can decrease health-related quality of life7 as it affects self-esteem and has problems with interpersonal relationships, social anxiety, and employment capability.8
Impact of visual impairment following stroke (IVIS study): a prospective clinical profile of central and peripheral visual deficits, eye movement abnormalities and visual perceptual deficits
Published in Disability and Rehabilitation, 2022
Fiona J. Rowe, Lauren R. Hepworth, Claire Howard, Kerry L. Hanna, Jim Currie
The types of strabismus and ocular motility disorders documented in this study were consistent with those reported in the literature with the most common form of strabismus being exotropia and the most common forms of ocular motility disorders being saccadic dysmetria and gaze palsies [1,10]. Often, strabismus in neurological conditions is due to coexistent ocular motility disorders, for example esotropia due to sixth nerve palsy or exotropia due to internuclear ophthalmoplegia. Isolated strabismus in neurological conditions is often a skew deviation [35,36]. However, a more common isolated neurological strabismus in stroke is exotropia which we confirm as prevalent in this study as in previous studies [5,37] and with the expected, but unusual, high number of asymptomatic cases in this particular form of cortical.
Thin-section 3D Steady-State MRI in Optic Nerve Coloboma
Published in Neuro-Ophthalmology, 2021
Krishnan Nagarajan, Anusha Venkataraman
A two-year-old boy presented with symptoms of divergent strabismus and visual impairment of his right eye. The child did not cooperate with vision testing. Right eye fundus examination revealed a ‘morning glory disc anomaly’ with a deepened optic disc suggestive of optic nerve coloboma. The macula was normal and there was no retinal detachment. Magnetic resonance imaging (MRI) was done to rule out other associated ocular and/or brain anomalies. The imaging was performed on a 1.5-T MRI scanner (HDX GE Healthcare, USA), using routine brain neuroimaging sequences. Fast Imaging Employing STeady-state Acquisition (FIESTA), a steady-state 3D sequence, was acquired at the level of orbits with the following parameters; TR, 4.8 ms; TE, 1.4 ms; slice thickness, 0.5 mm; FOV, 21 × 18.9 cm; matrix, 352 × 192; NEX, 4. A small defect of 1.5 mm diameter was noted in the optic nerve head with herniation of vitreous content into the defect confirming the coloboma (Figure 1a,b). The brain and left orbit were normal.
Related Knowledge Centers
- Amblyopia
- Brain Tumor
- Convergence Insufficiency
- Diplopia
- Down Syndrome
- Esotropia
- Strabismus
- Hydrocephalus
- Exophoria
- Cerebral Palsy