Cyclic exotropia associated with retinitis pigmentosa

Abstract

Cyclic exotropia may occur in patients with retinitis pigmentosa, an association that to the best of our knowledge has not been previously reported in the English ophthalmic literature. Cyclic exotropia is an unusual association with retinitis pigmentosa.

Cyclic exotropia in a child

“…To our knowledge, this is the first report of alternate-day exotropia after surgery for constant esotropia. Similar to the adult patients reported by Hwang and Kim,4 and Murthy and Hegde, 2 and 1 of the pediatric patients reported by Dawson and colleagues, 5 the alternate day exotropia in our patient resolved with horizontal muscle recession.…”

“…Our patient did not have evidence of any intraocular structural abnormalities such as those reported in the adult patients with cyclic exotropia. 2,4 Although she demonstrated small amplitude jerklike nystagmus waveforms on eye movement recording, our patient did not demonstrate nystagmus, which was noticeable on examination or suggestive of structural abnormality. Similar to the adult patient reported by Garg and Archer, 3 our patient developed cyclic exotropia after surgery to correct esotropia.…”

“…1 Of the types of cyclic strabismus, cyclic esotropia has been reported most often; there have been few reports of alternate-day exotropia in children. [2][3][4][5] Most cases of cyclic esotropia have been idiopathic and in children. Adult-onset cyclic esotropia has been reported with optic atrophy, unilateral traumatic aphakia, traumatic sixth nerve palsy, retinal detachment surgery, strabismus surgery, and central nervous system disease.…”

Acquired cyclic exotropia and hypotropia

“…5 Cyclic vertical deviations and cyclic exotropia appear to be very rare. [1][2][3][4] Cyclic vertical deviation has been described by Metz and colleagues 4 in a patient after craniofacial surgery. Clarke and Scott 11 described cyclic third nerve palsy.…”

Consecutive cyclic exotropia after surgery for adult-onset cyclic esotropia

“…[2][3][4] Adult-onset cyclic exotropia also has been described in a patient with severe vision loss due to retinitis pigmentosa. 6 Cyclic esotropia has been described after strabismus surgery, either recurrent after surgery for cyclic esotropia or new onset after surgery for noncyclic exotropia or esotropia. 1,7,8 That overcorrection on previously "straight days" does not generally occur after surgery has been taken as evidence that "these patients are basically strabismic with cycles of remission rather than straight with periods of esotropia."…”