J Korean Ophthalmol Soc.  2012 Aug;53(8):1138-1142. 10.3341/jkos.2012.53.8.1138.

Clinical Features Associated with the Direction of Deviation in Sensory Strabismus

• Park BG
• Kim JL
• Lee SG

• KMID: 2215957
• DOI: http://doi.org/10.3341/jkos.2012.53.8.1138

Abstract

PURPOSE
To assess the clinical features associated with the direction of deviation in sensory strabismus and postoperative stability of strabismus angles.
METHODS
The authors retrospectively reviewed the medical records of 98 patients diagnosed with sensory strabismus who were treated surgically. Among the factors analyzed were sex, age, direction of strabismus, preoperative visual acuity, age at onset of visual loss, cause of primary sensory deficit, refractive error, age at operation, deviation angle at 1 and 6 months postoperatively and after at least 5 years.
RESULTS
At baseline, 20 patients (20.4%) had esotropia and 78 (79.6%) had exotropia. Common causes of primary sensory deficit were corneal opacity (25.5%), vitreoretinal disorder (23.5%), and congenital cataracts (16.3%). The proportion of esotropia increased significantly as the refractive error of the sound eye became more hyperopic. The older the patients were when they lost their vision, the higher the proportion of exotropia. Patients with longer duration of vision loss were more likely to have a larger deviation angle with exotropia, but the association was not significant with esotropia.
CONCLUSIONS
Patients with sensory strabismus tend to develop exotropia. Refractive error of the sound eye and age at onset of vision loss were associated with the direction of strabismus. Despite poor sensory fusion even after surgery, more than 50% of patients maintained a stable eye position.

Keyword

Direction of sensory strabismus; Sensory esotropia; Sensory exotropia; Surgical outcome

MeSH Terms

Cataract
Corneal Opacity
Esotropia
Exotropia
Eye
Humans
Medical Records
Refractive Errors
Retrospective Studies
Strabismus
Vision, Ocular
Visual Acuity

Reference

1. Sondhi N, Archer SM, Helveston EM. Development of normal ocular alignment. J Pediatr Ophthalmol Strabismus. 1988. 25:210–211.

2. Havertape SA, Cruz OA, Chu FC. Sensory strabismus--eso or exo? J Pediatr Ophthalmol Strabismus. 2001. 38:327–330.

3. Graham PA. Epidemiology of strabismus. Br J Ophthalmol. 1974. 58:224–231.

4. Sidikaro Y, von Noorden GK. Observations in sensory heterotropia. J Pediatr Ophthalmol Strabismus. 1982. 19:12–19.

5. Von Noorden GK, Campos E. Binocular Vision and Ocular Motility. 2002. 6th ed. St. Louis: Mosby;345–357.

6. Edelman PM, Brown MH. The stability of surgical results in patients with deep amblyopia. Am Orthopt J. 1977. 27:103–106.

7. Sener EC, Mocan MC, Saraç OI, et al. Management of strabismus in nanophthalmic patients: a long-term follow-up report. Ophthalmology. 2003. 110:1230–1236.

8. Min BM, Min WK, Lee KM, Kim YB. Clinical evaluation of sensory heterotropia. J Korean Ophthalmol Soc. 1989. 30:767–772.

9. Kim KS, Park SC. The clinical consideration of sensory strabismus. J Korean Ophthalmol Soc. 2005. 46:316–322.

10. Havertape SA, Cruz OA. Sensory strabismus: when does it happen and which way do they turn? Am Orthopt J. 2001. 51:36–38.

11. Braendstrup P. The squinting position of weak-sighted eyes. Acta Ophthalmol. 1944. 22:386–393.

12. Cheng KP, Hiles DA, Biglan AW, Pettapiece MC. Visual results after early surgical treatment of unilateral congenital cataracts. Ophthalmology. 1991. 98:903–910.

13. Choi MY, Hwang JM. Clinical analysis of sensory strabismus with organic amblyopia in children. J Korean Ophthalmol Soc. 2005. 46:1374–1381.

14. Yoon KC, You IC, Park YG. Clinical analysis of sensory strabismus. J Korean Ophthalmol Soc. 2002. 43:2483–2488.