ANALYTICAL STUDY OF ESSENTIAL INFANTILE ESOTROPIA AND ITS MANAGEMENT
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 49
Abstract
BACKGROUND Essential Infantile Esotropia (EIE) is the most common type of strabismus. About 0.1% of the newborn are found to have esotropia.1 Though present since birth, it becomes manifest and remains constant around six months of age. The features are large angle constant strabismus, defective Binocular Single Vision (BSV), cross fixation, DVD and latent nystagmus. Most of the patients have mild-to-moderate hyperopia; the amount of deviation is unrelated to the amount and type of refractive error. MATERIALS AND METHODS Fifty cases with EIE were included in this prospective study. A thorough ophthalmic and orthoptic evaluation was done in all the patients. For patients more than three years of age, the angle of deviation was measured with prism bar cover test, and for patients less than three years of age, angle of deviation was measured with Hirschberg’s test. Associated features like cross fixation, abduction limitation, Dissociated Vertical Deviation (DVD), nystagmus, amblyopia and Inferior Oblique Overaction (IOOA) were documented. Occlusion therapy was given to amblyopic patients prior to surgery. All these patients underwent surgery and were followed up for a period of six months. RESULTS The prevalence of EIE in our centre was 0.33%. Of the fifty patients, 28 were males and 22 were female patients. 39 patients (78%) had deviation of 30-50 Prism Dioptres (PD). Incidence of DVD, inferior oblique overaction and nystagmus was found to be lower when compared to western population. Amblyopia should be diagnosed early and treated adequately before surgery. Standard surgical option is bimedial recession. Monocular recession-resection surgery in one eye can be opted for in cases of irreversible amblyopia. Three or four muscle surgery can be done if deviation is very large. If marked inferior oblique overaction is present, the same should be weakened in addition to the horizontal muscle surgery. CONCLUSION EIE is the most common type of strabismus. These patients have large and constant angle of deviation. Most of them have mild-to-moderate hyperopia. Amblyopia should be diagnosed early and treated promptly before surgery. Patients show limitation of abduction, cross fixation, dissociated vertical deviation, inferior oblique overaction and nystagmus. Early surgery within two years gives best visual outcome in the form of binocular vision and stereopsis.
Authors and Affiliations
Kandasamy Sivakumar, Periasamy Geetha
Keywords
Related Articles
- EP ID EP220174
- DOI 10.18410/jebmh/2017/597
- Views 100
- Downloads 0
SARCOMATOID CARCINOMA OF PENIS: A RARE PENILE NEOPLASM
Sarcomatoid carcinomas are high grade, biphasic, uncommon neoplasms which can occur in any part of the body. Sarcomatoid carcinoma of penis is very rare representing only 1% - 2% of all penile cancers. Only a few cases o...
COMPARISON STUDY OF COUGH SUPPRESSION DURING FLEXIBLE BRONCHOSCOPY USING LOCAL ANAESTHESIA IN DIFFERENT TECHNIQUES- (10% LIGNOCAINE SPRAY + 2% LIGNOCAINE AS YOU GO) VERSUS (4% LIGNOCAINE NEBULISATION + 2% LIGNOCAINE AS YOU GO)
BACKGROUND Anaesthesia for bronchoscopy poses unique challenges for the pulmonologist. By definition, bronchoscopy is an endoscopic technique to visualise the inside of the airways, it is a pivotal diagnostic and therape...
A STUDY OF EFFICACY OF PROSTAGLANDIN ANALOGUES IN COMPARISON WITH TIMOLOL MALEATE AS FIRST DRUG OF CHOICE IN THE TREATMENT OF PRIMARY OPEN-ANGLE GLAUCOMA
BACKGROUND Glaucoma is an ischaemic optic neuropathy comprising of three entities; one is raised intraocular pressure, second one is optic disc changes and third one is visual field defects. Intraocular pressure remains...
DIAGNOSIS OF MDR TUBERCULOSIS AT A TERTIARY CARE CENTRE WITH CBNAAT TECHNOLOGY- A TWO YEAR STUDY
BACKGROUND Tuberculosis is a chronic multi system granulomatous disease with a predilection for the respiratory system. Traditional diagnostic protocols include history, chest x-ray and sputum collection and staining for...
A CLINICAL STUDY OF CASE PROFILE, MATERNAL AND FETAL OUTCOME IN PREGNANCY WITH CARDIAC DISEASE
Cardiac disease complicates about 1% of pregnancies. It is a major cause of maternal morbidity & mortality. AIM: To study clinical profiles of pregnant women with cardiac diseases and the maternal and fetal outcome cases...