Congenital Esotropia and the Risk of Mental Illness by Early Adulthood

Olson, Joshua; Louwagie, Curtis R.; Diehl, Nancy N.; Mohney, Brian G.

doi:10.1016/j.ophtha.2011.06.035

Cited by 25 publications

(33 citation statements)

References 18 publications

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“…6–8,12–14 Toyota and co-investigators identified alanine-specific deletion mutations in PMX2B, a gene encoding a neurodevelopmental transcription factor, to be strongly associated with the development of schizophrenia and constant exotropia in adults. 8 Schiffman et al has shown that subjects who eventually develop schizophrenia disorder demonstrate higher frequency of strabismus compared to matched subjects with an outcome of other psychopathology or those with no psychiatric diagnosis in adulthood.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 Patients with congenital esotropia have also been found to be 2.6 times more likely to develop a mental illness by early adulthood compared to those without the condition. 14 These associations between mental illnesses and strabismus, both of which have strong genetic bases, suggest that certain genes may be redirecting neural development in ways that increase the risk for both. In the current study, there was no statistically significant association between parents with schizophrenia or another psychiatric illness, and the development of strabismus in their children, but whether there are specific neural mechanisms that lead to both mental illness and strabismus remain to be determined.…”

Section: Discussionmentioning

confidence: 99%

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Surgical Correction of Childhood Intermittent Exotropia and the Risk of Developing Mental Illness

Kilgore

Barraza

Hodge

et al. 2014

American Journal of Ophthalmology

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Purpose To assess whether successful surgical intervention for intermittent exotropia, or the timing of intervention, has any effect on the development of mental illness. Design Retrospective observational case series Methods All patients (< 19 years) diagnosed with intermittent exotropia in Olmsted County, Minnesota, from January 1, 1975, through December 31, 1994, were retrospectively reviewed. Potential cases were identified using the resources of the Rochester Epidemiology Project, a medical records database designed to capture data on any patient-physician encounter in Olmsted County, Minnesota. The main outcome measures were the occurrence and severity of mental illness among those who underwent strabismus surgery compared to those who did not. Results Ninety-six (52%) of the 184 children identified were diagnosed with a mental illness at a mean age of 23.3 years (range 6 to 41 years). Thirty-five (36%) of the 96 children who developed mental illness underwent strabismus surgery. Success at surgery (< 10 prism diopters) was not associated with a decreased occurrence of mental illness (p=0.30). Of the 88 patients who did not develop mental illness, strabismus surgery was not more commonly performed (p=0.54) nor was it performed at a younger age (p=1.0), when compared to the 96 patients who later developed mental illness. Conclusions Strabismus surgery for children with intermittent exotropia, regardless of success or age at surgery, did not alter the development of mental illness by early adulthood.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surgical Correction of Childhood Intermittent Exotropia and the Risk of Developing Mental Illness

Kilgore

Barraza

Hodge

et al. 2014

American Journal of Ophthalmology

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“…1,2 These children also had significantly increased numbers of psychiatric diagnoses and children with exotropia had more psychiatric-related emergency department visits and hospitalizations, and suicidal and homicidal ideation than their sex- and birthdate-matched controls. Given that children with CI were found to be at an increased risk for developing mental illness, adults with CI may similarly be expected to be at an increased risk.…”

Section: Discussionmentioning

confidence: 97%

“…Children diagnosed with some forms of strabismus (intermittent exotropia, convergence insufficiency and congenital esotropia) were recently found to have a three-fold increased incidence of developing mental illness by early adulthood compared to controls. 1,2 Additionally, children with intermittent exotropia had more mental health emergency department visits, mental health hospitalizations, and suicidal or homicidal ideation when compared to their controls. Children with congenital esotropia were prescribed more psychotropic medications than their controls.…”

Section: Introductionmentioning

confidence: 97%

Prevalence of Mental Health Illness among Patients with Adult-Onset Strabismus

2015

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Background Children diagnosed with some forms of strabismus were recently found to have an increased risk of developing mental illness by early adulthood. The purpose of this case-controlled study was to determine if adults with non-paralytic forms of strabismus are similarly at an elevated risk for developing mental illness. Methods The medical records of all patients diagnosed as adults (≥ 19 years of age) with convergence insufficiency (CI, n=118), divergence insufficiency (DI, n=80), and small angle hypertropia (HT, n=99) from January 1, 1985, through December 31, 2004, were retrospectively reviewed. Each case was compared with a sex- and birthdate-matched non-strabismic control. The medical records were reviewed for mental health diagnoses, including inpatient and outpatient encounters, psychiatric ER visits, and medication use. Results Mental health disorders were diagnosed in 65 (55.1%) patients with CI compared to 54 (45.8%) controls (p=0.15), in 51 (63.8%) patients with DI compared to 42 (52.5%) controls (p=0.15), and in 63 (63.6%) patients with HT compared to 57 (57.6%) controls (p=0.38). CI patients were not more likely to have mental health disorders than their controls (p=0.15). Mental health hospitalizations (p=0.02), psychiatric medication use (p=0.04), and unspecified anxiety disorders (p=0.03) were higher in DI patients compared to controls. HT patients were found to have more generalized anxiety disorders (p=0.003) than controls. Conclusions Adults with some forms of strabismus (DI and HT) appear to have an increased risk of mental illness and its comorbidities, compared to age- and gender-matched non-strabismic controls.

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“…Correspondence to: Nasir Ahmed Chaudhary Institute of Ophthalmology, Mayo Hospital, Lahore Email: Drnasirch1@gmail.com myths often considering a strabismic person to be of low Intelligent Quotient and sign of bad destiny has also contributed in affecting the life of these patients 6 . Symptoms include disturbed vision, double vision, headache, eye strain, abnormal posturing of head and easy fatigability after reading 7 . Newborns often have misalignment that resolves spontaneously.…”

Section: Stereotypicalmentioning

confidence: 99%

Practice Patterns in the Management of Strabismus in Pakistan

Ahmed¹,

Shaheer²,

Zahoor³

et al. 2020

pak J Ophthalmol

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Purpose: To study the current practice patterns of pediatric ophthalmologists in the management of strabismus in Punjab. Study Design: Questionnaire based Practice pattern survey. Place and Duration of Study: Teaching hospitals of Punjab from July 2018 to July 2019. Material and Methods: This study was conducted at ophthalmology departments of various teaching hospitals of Punjab. A questionnaire was designed to find out the current practice pattern for management of strabismus. Ophthalmologists who were members of Ophthalmological Society of Pakistan (OSP), having their expertise in strabismus surgery for more than 5years and practicing pediatric ophthalmology were selected. Discussion was also held regarding questionnaire and practices being performed after filling the proforma. This data was compiled, analyzed and was converted to a summary in points. Results: We contacted 90 ophthalmologists out of whom 76 responded to our Questionnaire. Complete Orthoptic Assessment was performed by only 46% (35) of the ophthalmologists. Prism cover test was used as a diagnostic tool by 70 (92%) ophthalmologists. Rest of the ophthalmologists used Synoptophore with it. Percentage of ophthalmologists performing cycloplegic refraction was very low. Only 5 (6.57%) surgeons used adjustable sutures. Only 46% of surgeons used to explain the complications of Anesthesia. More than 90% of surgeons explained the surgical procedures being done, its complications, post-operative care and need to use glasses or need for orthoptic exercises. All the surgeons kept follow up of the patients on 1st post-operative day. Conclusion: The current practices in strabismus need to be standardized and a consensus should be developed at a national level.

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Congenital Esotropia and the Risk of Mental Illness by Early Adulthood

Cited by 25 publications

References 18 publications

Surgical Correction of Childhood Intermittent Exotropia and the Risk of Developing Mental Illness

Surgical Correction of Childhood Intermittent Exotropia and the Risk of Developing Mental Illness

Prevalence of Mental Health Illness among Patients with Adult-Onset Strabismus

Practice Patterns in the Management of Strabismus in Pakistan

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