Reduction of deviation angle during occlusion therapy: in partially accommodative esotropia with moderate amblyopia.
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PURPOSE: To evaluate changes in ocular alignment in partially accommodative esotropic children age ranged from 3 to 8 years during occlusion therapy for amblyopia. METHODS: Angle measurements of twenty-two partially accommodative esotropic patients with moderate amblyopia were evaluated before and at 2 years after occlusion therapy. RESULTS: Mean deviation angle with glasses at the start of occlusion treatment was 19.45+/-5.97 PD and decreased to 12.14+/-12.96 PD at 2 years after occlusion therapy (p<0.01). After occlusion therapy, 9 (41%) cases were indications of surgery for residual deviation but if we had planned surgery before occlusion treatment, 18 (82%) of patients would have had surgery. There was a statistical relationship between increase of visual acuity ratio and decrease of deviation angle (r=-0.479, p=0.024). CONCLUSIONS: There was a significant reduction of deviation angle of partially accommodative esotropic patients at 2 years after occlusion therapy. Our results suggest that occlusion therapy has an influence on ocular alignment in partially accommodative esotropic patients with amblyopia. (+info)
Direction-of-motion detection and motion VEP asymmetries in normal children and children with infantile esotropia.
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PURPOSE: To investigate nasal-temporal asymmetries in the detection of horizontal motion and in cortical motion visual evoked potential (mVEP) responses in normal infants and children and in patients with infantile esotropia. METHODS: Monocular motion-detection thresholds were obtained separately for nasalward- and temporalward-moving random-dot patterns in a forced-choice, preferential-looking paradigm. Monocular mVEP responses were obtained while subjects viewed a 6-Hz oscillating, 1 cyc/deg vertical sine-wave grating. Nasal-temporal mVEP asymmetry was investigated with two measures from each subject: asymmetric indices (AIs) and interocular phase differences. Performance was compared in 33 visits of 28 normal subjects and 73 visits of 54 patients with infantile esotropia, ranging in age from 2 months to 5 years. RESULTS: At 3 to 5 months of age, both normal infants and patients with infantile esotropia had robust nasal-temporal asymmetries in motion-detection and mVEP measures. By 2 years of age, measures in all normal subjects were symmetric, as they were in patients successfully treated with glasses or alignment surgery, whereas patients who had not yet undergone alignment surgery, regardless of surgery status, had highly asymmetric mVEP responses and motion-detection thresholds. CONCLUSIONS: Young normal and esotropic infants exhibited nasal-temporal asymmetries in both motion detection and mVEP. These asymmetries similarly disappeared over time in normal infants and in patients with esotropia who had received successful, timely correction of misalignment. Although the initial capacity for motion processing is normal in the youngest patients with untreated esotropia at 5 months, cumulative abnormal binocular experience in these patients may disrupt motion mechanisms. (+info)
The clinical course of consecutive esotropia after surgical correction.
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PURPOSE: To investigate the clinical course in patients who underwent surgical correction of consecutive esotropia. METHODS: The medical records of 13 patients who underwent surgical correction of consecutive esotropia were reviewed retrospectively. The authors investigated the deviation and surgical method at the time of exotropia surgery. During the follow up period, the authors also studied incidence of amblyopia development, the effect of occlusion therapy, surgical methods for consecutive esotropia, and postoperative change of deviation. RESULTS: The average exodeviation was 27.1 prism diopter (PD). Bilateral lateral rectus muscle recession was performed in all patients. In all patients, alternate occlusion was tried from 2 weeks after development of consecutive esotropia. However, there was no effect on 7 patients. None of the patients developed amblyopia. Surgery for consecutive esotropia was performed on the average 15.3 months after exotropia surgery. The average esodeviation was 21.1PD. Medial rectus muscle recession was performed in 10 patients and lateral rectus muscle advancement in 3 patients. The average deviation of the subject group immediately after surgery was 1.2PD esodeviation, 0.9PD esodeviation one month after surgery, 2.4PD exodeviation 6 months after surgery, and 4.7PD exodeviation at the last follow up, and it showed a tendency to progress to exodeviation as the follow up period increased. Ten patients (76.9%) showed deviation within 8PD at the last follow up. CONCLUSIONS: The success rate of surgical correction for consecutive esotropia was a favorable outcome. But, careful decisions of the surgical method and amount is needed because the conversion of exodeviation during long-term follow-up is possible. (+info)
Duration of binocular decorrelation predicts the severity of latent (fusion maldevelopment) nystagmus in strabismic macaque monkeys.
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Treatment outcomes in VI nerve palsy corrected by Carlson & Jampolsky technique.
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PURPOSE: To study the results of Carlson & Jampolsky technique in 31 patients with VI nerve palsy. METHODS: We had 23 unilateral and 8 bilateral cases. The mean unilateral preoperative esotropia was 56.8 PD +/- 24 PD (30 PD to 100 PD) and they had a mean postoperative follow-up of 14 +/- 17.9 months (3 to 72). The mean bilateral preoperative esotropia deviation angle in primary position was 74.5 PD +/- 20.7 PD (45 PD to 100 PD) and the mean postoperative follow-up was 14.7 +/- 15.7 months (4 to 47). RESULTS: In the unilateral group, 18 patients had good results and reoperation was not necessary. Out of 5 patients who were reoperated (2 undercorrections and 3 overcorrections), 2 had to use prismatic glasses. Among the bilateral patients, 2 cases were reoperated (1 undercorrection and 1 overcorrection), and the undercorrected patient remained with esotropia (ET13 PD), and also had to use prismatic glasses. CONCLUSIONS: Carlson & Jampolsky technique was useful to treat patients with VI nerve palsy. We had low reoperation rates and, among the 7 patients who needed a second intervention, only 3 did not achieve good results. (+info)
Concordant eye movement and motion parallax asymmetries in esotropia.
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