Outcome of treatment in accommodative esotropia — how often do we restore binocular vision?
Jan-Tjeerd de Faber in 28th European Strabismological Association Meeting, 2020
Accommodative esotropia although initially intermittent, tends to progress to a constant deviation if treatment is delayed. Constant esotropia can then lead to permanent loss of central binocular vision. Early effective therapeutic intervention during the intermittent esotropia phase or within a few months of the development of a constant deviation appear therefore necessary if bifixation is to be maintained. Wilson et al (1993) concluded that patients with intermittent esotropia at presentation were nearly three times more likely to remain bifixators over time than patients presenting with constant esotropia. If deterioration of ocular alignment occurs later, or amblyopia is detected, early and aggressive intervention is necessary to prevent loss of bifixation. The following data is from this particular article: Patients with bifixation had stereopsis of 50 seconds of arc or better and central fusion was demonstrated for example with Bagolini glasses. They presented 24 % of the patients with an average follow up time of 89 months. Monofixation patients had stereopsis worse than 60 arc seconds with evidence of peripheral fusion on the Worth four-dot test. A macular scotoma was demonstrated for example with Bagolini striated glasses. They presented 76 % of the patients with an average follow up of 84 months. Primary monofixaton syndrome patients were excluded.
Carbohydrate and glycosylation disorders
Steve Hannigan in Inherited Metabolic Diseases: A Guide to 100 Conditions, 2018
Symptoms usually appear shortly after birth. In the infantile stage of the disorder, they commonly include feeding problems, including vomiting and diarrhoea, which can lead to failure to gain weight and grow (failure to thrive), as well as a delay in physical and mental development and a loss of muscle tone (hypotonia). There may also be an enlarged liver (hepatomegaly), dysfunction of the liver, inverted nipples, abnormal distribution of fat pads, and squinting. Certain parts of the brain may be underdeveloped (olivopontocerebellar atrophy), and there may be a collection of fluid in the sac that surrounds the heart (pericardial efusion), disease of the heart muscle (cardiomyopathy) and restricted movement of some of the joints of the limbs. Other symptoms include crossed eyes (esotropia), seizures and a tendency to have problems with bleeding. Other organs may also be afected.
Ophthalmology
Stephan Strobel, Lewis Spitz, Stephen D. Marks in Great Ormond Street Handbook of Paediatrics, 2019
Infantile esotropia (Fig. 7.63) develops before the age of 6 months with a large and stable angle, crossfixation (child uses right eye to look to left and vice versa as the eyes are so convergent) and normal refraction for age. Non-accommodative esotropia: esotropia after 6 months of age with normal refraction.Refractive accommodative esotropia: onset is usually between 2 and 3 years, associated with hypermetropia (long-sightedness).Non-refractive accommodative esotropia: onset after 6 months but before 3 years. No significant refractive error but excessive convergence for near (called high accommodative convergence: accommodation ratio – AC/A ratio).Sensory esotropia: due to reduction in vision, with one eye much worse than the other, which disrupts fusion – e.g. in unilateral cataract.Convergent spasm: intermittent esotropia with pseudomyopia and miosis due to accommodative spasm, which may be seen after trauma or due to a posterior fossa tumour but usually has a functional element.
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
Sodium Channel Myotonia and a Novel Gly701Asp Mutation in the SCN4A Gene: From an Ophthalmological Symptom to a Familial Disease
Published in Neuro-Ophthalmology, 2021
Filipa Sampaio, Sérgia Soares, Sara Pereira, José Alberto Lemos, Ágata Mota
The Gly701Asp identified in this family is a novel mutation. Different family members with this mutation presented with different clinical manifestations and disease severity. The most interesting characteristic was that the child presented with a simple strabismus and ptosis initially, and only on further observations was the myotonic phenomena of the eyelids recognised, which led to neurological investigation by a Neuro-paediatrician and Neurologists. Studies that previously reported ocular myotonia with extraocular muscle involvement identified a V445 M mutation.15,16 Du et al. described a big family with myotonia congenita in which all affected individuals were diagnosed with esotropia between the ages of three and six, and had at least one surgery in both eyes for strabismus, and additionally eyelid myotonia.16 It has been speculated that esotropia may be caused by slightly nasally displaced superior and inferior rectus muscles, as well as an inferiorly displaced lateral rectus muscle.8
Selected Ophthalmological Features in Children with Septo-Optic Dysplasia and Optic Nerve Hypoplasia
Published in Neuro-Ophthalmology, 2022
Michael S. Salman, Shakhawat Hossain, Elizabeth Carson, Chelsea A. Ruth, Ian H. Clark
Strabismus is common in patients with SOD/ONH and its prevalence varies from 13.8% to 92.5% (Table 4). It was very commonly seen in our cohort, likely reflecting the high prevalence of patients with asymmetrical bilateral and unilateral ONH, as documented previously.28 Untreated childhood manifest strabismus is a common cause of amblyopia and should therefore be identified and treated. Superimposed amblyopia may also occur secondary to anisometropia, or other refractive errors, so these should also be addressed.1,31 Both esotropia and exotropia were common, but BCVA of the worse eye on last clinic visit was more impaired in patients with esotropia. Esotropia has been reported to occur more commonly in patients with early onset visual loss;32 this would be associated with a worse visual outcome and higher risk of additional visual loss through suppression and amblyopia.
Related Knowledge Centers
- Amblyopia
- Diplopia
- Exotropia
- Eye
- Refractive Error
- Strabismus
- Emmetropia
- Esophoria
- Eye Surgery
- Far-Sightedness