1/12. Spontaneous resolution of infantile esotropia.PURPOSE: To report the spontaneous resolution of infantile esotropia in 3 patients. methods: The clinical histories and the results of ophthalmologic examinations in 3 patients with infantile esotropia were reviewed and analyzed with reference to the literature. RESULTS: All 3 patients with infantile esotropia were diagnosed with 25 to 30 PD of esotropia before the age of 6 months. All of them had insignificant refractive errors. Against medical advice, they were not brought in for follow-up examinations. At the age of 34 months to 59 months, the esotropia of the patients had changed into exophoria, esophoria less than 4 PD, or orthophoria. All patients eventually showed dissociated vertical deviation and overaction of the inferior oblique muscles. Of the 2 cooperative patients, 1 consistently identified Titmus stereograms with 3000 seconds of arc and fused Worth 4 dots at near and at distance. The other patient could not identify stereo targets and suppressed one eye on Worth 4 testing at distance, though she showed no suppression at near. CONCLUSION: In these cases, infantile esotropia with a relatively small angle may spontaneously resolve without any treatment. However, all these patients showed poor stereoacuity, dissociated vertical deviation, and overaction of the inferior oblique muscles.- - - - - - - - - - ranking = 1keywords = esotropia (Clic here for more details about this article) |
2/12. Idiopathic macular hypoplasia: a report of four cases and refinement of the phenotype of so-called ateliotic macula.PURPOSE: To refine the phenotype of idiopathic macular hypoplasia, also referred to as ateliotic macula, by describing a series of cases with this diagnosis. methods: A review of the clinical characteristics of four patients as documented in medical records with regard to refractive error, visual acuity, anterior segment examination, retinal findings, and ancillary tests such as electroretinography (ERG). RESULTS: All patients had oval circumscribed or diffuse areas in the posterior pole where the retina appeared not to have developed normally; the fovea was involved in three patients with reduced visual acuity, and one patient had parafoveal lesions with preserved visual acuity. There were three males and one females. patients' age ranged from 4 to 16 years. Errors of refraction ranged from severe myopia to hypermetropia and mild astigmatism. The anterior segment was normal in all patients. Three patients had strabismus and two had nystagmus. ERG was normal in the one patient in whom it was performed. One patient was mosaic for trisomy of chromosome 9. CONCLUSIONS: The term idiopathic macular hypoplasia can be applied to a spectrum of abnormalities in which a localized area of the posterior pole has a primordial or underdeveloped appearance. Lesions involving the fovea result in poor acuity. Generalized retinal dysfunction is absent. At least one of the genes involved in macular development may be located on chromosome 9.- - - - - - - - - - ranking = 0.043700291086375keywords = strabismus (Clic here for more details about this article) |
3/12. Ocular findings in four children with mucopolysaccharidosis i-Hurler (MPS I-H) treated early with haematopoietic stem cell transplantation.PURPOSE: To present visual functions and ocular findings in four children with mucopolysaccharidosis i-Hurler (MPS I-H) treated early with stem cell transplantation (SCT). methods: Clinical ophthalmological evaluations including visual evoked potentials (VEPs) were carried out. RESULTS: stem cell transplantation was performed before 20 months of age. Ocular follow-up lasted 1.3-5.6 years (median 4.1 years). Reductions in corneal opacities were observed in all four children post-SCT, but a slight cloudiness persisted. Decreased visual acuity and high hyperopia (median 6.25 dioptres, range 4.0 D to 7.5 D spherical equivalents) were noted in all children. hyperopia was initially undetected due to dull retinal reflexes and photophobia. Two children developed esotropia, one with amblyopia. Keratometry, performed in two children, demonstrated subnormal values with a mean of 39.33 D (range 37.62-41.00 D). Visual evoked potentials and intraocular pressures were normal. Neither cataract nor dry eye were detected during follow-up. CONCLUSIONS: Early SCT appears to be beneficial in reducing, but not eliminating, corneal opacities in children with MPS I-H. Subjects are at risk of developing high hyperopia and esotropia. hyperopia might be caused by the storage of glucosaminoglucans that increase corneal rigidity, thereby straightening the curvature of the cornea and reducing refractive power. As early diagnosis and treatment are very important, paediatric ophthalmologists should remember to rule out MPS I-H in children with corneal opacities.- - - - - - - - - - ranking = 0.2keywords = esotropia (Clic here for more details about this article) |
4/12. Prevention and care of strabismus in infants and pre-school children.Care of children at risk of developing strabismus is discussed. Recommended care consists of parental counseling combined with early and periodic examinations. Examinations should begin by age 3 weeks and continue at 3-6 month intervals until the child reaches age 5. Treatment of strabismus or amblyopia should begin as soon as these conditions exist. Using recent electrophysiological research as a background, a model care for infants with congenital strabismus is presented. Care reports are presented describing results of orthoptic treatment of non-congenital strabismus.- - - - - - - - - - ranking = 0.349602328691keywords = strabismus (Clic here for more details about this article) |
5/12. amblyopia and the monofixation syndrome.Children with a Monofixation syndrome often show a small angle constant esotropia with an overlying esophoria of variable and often large angle. Commonly the phoria is well controlled unless the child is very tired, or the eyes are dissociated. Treatment of a concomitant amblyopia by patching may result in an inability to control the phoria, with breakdown of the strabismic angle to a large esotropia. Illustrative cases are presented.- - - - - - - - - - ranking = 0.2keywords = esotropia (Clic here for more details about this article) |
6/12. Normalization of binocular VERs after early onset visual deprivation in man.Visually evoked responses (VERs) were elicited by a reversing checkerboard target from a patient who suffered early onset bilateral deprivation of form vision as a result of a high refractive error, large amplitude strabismus, and congenital nystagmus. Monocular and binocular steady-state VERs were abnormal in amplitude and wave form even when a correction for the patient's large refractive error (compound hyperopic astigmatism) was worn. Although monocular VERs could not be normalized, a normal wave form and amplitude were restored to the binocular VER by the addition of horizontal prisms to the patient's ophthalmic prescription. The initially degraded binocular VER gradually acquired a normal morphology and amplitude as the magnitude of compensating base-out prisms in the patient's habitual ophthalmic prescription was systematically increased. The relationship between the binocular VER amplitude and the correcting prisms derived by the method described in this paper was subsequently used to arrive at a practical clinical solution for the patient's unusual and debilitating visual symptoms. This electrophysiological evaluation of binocular function at the cortical level proved to be a very useful diagnostic procedure with prognostic value; standard clinic procedures were ineffective in elaborating the patient's sensory and oculomotor disorders. The theoretical and practical implications of managing patients with a history of early onset visual deprivation are discussed.- - - - - - - - - - ranking = 0.043700291086375keywords = strabismus (Clic here for more details about this article) |
7/12. Therapy for early acquired noncomitant esotropia. A case report.A 7 year-old female demonstrated a noncomitant esotropia secondary to an early acquired lateral rectus paresis. Sensory fusion testing indicated that the patient was capable of maintaining single binocular vision only with a pronounced head turn. Prism and surgical therapy reduced the abnormal head posture and permitted fusion and stereopsis in the primary position.- - - - - - - - - - ranking = 0.5keywords = esotropia (Clic here for more details about this article) |
8/12. Congenital blepharoptosis, anisometropia, and amblyopia.A review of the records of 65 patients who had surgery for congenital blepharoptosis of the upper eyelid during a three-year period revealed the preoperative presence of anisometropia, strabismus, or amblyopia in 19 patients. Postoperatively, ten of the 65 patients developed or increased their astigmatism in the operated eye. In four of these patients amblyopia attributed to this postoperative astigmatism developed. The results of our study suggest that blepharoptosis surgery done in the first few years of life may contribute to the development of astigmatism and amblyopia in some patients.- - - - - - - - - - ranking = 0.043700291086375keywords = strabismus (Clic here for more details about this article) |
9/12. Antipodean squint.Strabismic cases which are exotropic fixing with one eye, and esotropic fixing with the other eye are rare and a result of anisometropia, unequal accommodation, paresis or restriction, and previous ocular muscle surgery. Three cases of antipodean squint are reported without known etiology factor. An extensive survey of experts in the field of strabismus was unable to document other similar cases where a cause could not be determined.- - - - - - - - - - ranking = 0.043700291086375keywords = strabismus (Clic here for more details about this article) |
10/12. Progressive increase in the angle of deviation in congenital esotropia.The majority of patients with congenital esotropia in this consecutive series of 41 patients showed an increase in the angle of deviation when followed over an average of 3 months. The ages at the initial measurement and surgery, the cycloplegic refraction, and the clinical response to patching could not be used to identify those patients with a progressive increase in the quantity of the deviation. It was found, however, that if the preliminary surgical plan was adjusted (as it was in the majority of the patients in this series) to reflect the latest measurements obtained the day before surgery, a relatively high percentage of patients (90%) could be found to have achieved satisfactory alignment by the 6-week postoperative visit.- - - - - - - - - - ranking = 0.5keywords = esotropia (Clic here for more details about this article) |
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