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

INDUCTION AND MAINTENANCE OF ANAESTHESIA BY TWO DIFFERENT INTRAVENOUS ANALGESIC AND SEDATIVE COMBINATION WITHOUT USE OF VOLATILE AGENTS- A CONTROLLED COMPARATIVE CLINICAL STUDY IN DIABETIC AND HYPERTENSIVE PATIENTS

BACKGROUND In developing country like India with limited resources we need to find ways and means of cutting the anaesthetic cost without compromising safety of patient. With the availability of various intravenous analg...

VICARIOUS RENAL EXCRETION OF ORAL IODINATED CONTRAST IN A PATIENT WITH PANCREATIC CARCINOMA

PRESENTATION OF THE CASE An 84 year old male presented with a history of chronic bladder outlet obstruction symptoms, painless jaundice, reduced appetite, weight loss & long-standing abdominal pain. IMAGING FINDINGS USG...

A COMPARATIVE STUDY OF DEXMEDETOMIDINE AND CLONIDINE IN EPIDURAL ANAESTHESIA WITH ROPIVACAINE FOR LOWER ABDOMINAL AND LOWER LIMB SURGERY

BACKGROUND Epidural anaesthesia using Inj. Ropivacaine results in an effective anaesthesia and postoperative analgesia and addition of adjuvants would be advantageous. Clonidine and dexmedetomidine are α2-agonists used a...

ACUTE KIDNEY INJURY IN PATIENTS WITH CIRRHOSIS- CAUSES AND OUTCOME

BACKGROUND Acute Kidney Injury (AKI) is a common complication in patients with cirrhosis leading to high mortality. Creatinine-based criteria for defining AKI are validated in general hospitalised patients, but their app...

COMPARISON OF POSTOP SIA IN MSICS WITH STRAIGHT INCISION VERSUS FROWN INCISION

BACKGROUND Surgically-Induced Astigmatism (SIA) is one of the commonest causes of poor postoperative vision even after uneventful cataract surgery. Recent advances have led to a newer concept of “refractive cataract surg...

Download PDF file
  • EP ID EP220174
  • DOI 10.18410/jebmh/2017/597
  • Views 106
  • Downloads 0

How To Cite

Kandasamy Sivakumar, Periasamy Geetha (2017). ANALYTICAL STUDY OF ESSENTIAL INFANTILE ESOTROPIA AND ITS MANAGEMENT. Journal of Evidence Based Medicine and Healthcare, 4(49), 3016-3019. https://europub.co.uk/articles/-A-220174