Cyclic exotropia in a child

Thyparampil, Preeti J.

doi:10.1016/j.jaapos.2010.08.012

Cited by 8 publications

(3 citation statements)

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“…Despite its cyclic pattern of onset, cyclic strabismus will eventually convert to a permanent strabismus with time [3]. There have been various limited accounts describing this unusual form of strabismus, the vast majority being case reports or series due to the infrequency of the condition [2,[4][5][6][7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…Even an investigator who dedicated a tremendous amount of his time and efforts to studying the biological clock mechanism and proved their relationship and roles in many aspects of biological human functions including behavior and metabolism, could not find an explanation for the circadian pattern of cyclic strabismus [16]. Even in the presence of cases being reported following visual compromise, trauma, strabismus surgery, and central nervous system pathology, the underlying etiology of cyclic strabismus remains unknown and its etiology is still considered to be idiopathic [4,6,8,12,[19][20][21].…”

Section: Introductionmentioning

confidence: 99%

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Cyclic Esotropia Managed With Botulinum A Toxin Injections: A Report of Four Cases and Literature Review

Abdelaal,

Alhemidan,

Alabdulqader

et al. 2023

Cureus

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Cyclic strabismus is a rare entity and is unique in that patients follow variable but reliable time cycles where they alternate between orthotropia or “straight” eyes and strabismus, most commonly in the form of esotropia. Despite many theories on the underlying etiology and unique features of this diagnosis, none have been proven and its pathophysiology remains unknown. Four cases of cyclic esotropia diagnosed by pediatric ophthalmologists have been included in this report. The ages of the patients ranged from 10 months to eight years. The time duration from the onset of deviation to presentation to an ophthalmologist ranged from 1-52 weeks with three of the four patients presenting in the cyclic phase and the fourth presenting with a constant esotropia after a clear history and photographically documented cyclic esotropia for the preceding two months. All four patients were followed for periods ranging from one to four months to confirm their diagnosis or obtain multiple readings of the maximal deviation on the strabismic days before any intervention. The angle of esotropia when present ranged from 25 to 35 prism diopters and the cycle duration was 48 hours for all four cases (24 hours of esotropia followed by 24 hours of orthotropia). All patients were treated with botulinum toxin A injections to both medial recti, which resulted in an end to their cyclic deviation with excellent alignment obtained during follow-up periods ranging from 12-36 months for all cases. Cyclic esotropia is an elusive diagnosis that can be easily overlooked. When identified, classical treatment is usually extraocular muscle surgery targeting the largest angle of deviation. Many non-surgical treatments have been tried to no avail. However, in recent times, botulinum toxin A has been seen as a viable alternative.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cyclic Esotropia Managed With Botulinum A Toxin Injections: A Report of Four Cases and Literature Review

Abdelaal,

Alhemidan,

Alabdulqader

et al. 2023

Cureus

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show abstract

“…Reports have been published of cyclic deviations in association with unilateral aphakia, 10 optic atrophy, 11 fibrous dysplasia, 12 retinitis pigmentosa, 13 ocular myositis, 14 thyroid eye disease, 15 traumatic abducens nerve palsy, 16 and following retinal detachment surgery, 17 trabeculectomy, 18 and strabismus surgery. [19][20][21][22][23] The cycles are usually in 24-hour increments, with a 48-hour cycle being the most common, although 36-, 72-, and 96-hour cycles have been reported. [3][4][5]11,19 In the classic, 48-hour cycles, strabismus is present for 24 hours and absent for the next 24 hours.…”

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confidence: 99%