Sensory exotropia due to keratoconus and review of the literature

Ciftci, Suleyman; Şimşek, Ali; Dogan, Eyup; Ciftci, Leyla

doi:10.2147/opth.s53397

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…Concerning post-traumatic strabismus, it has been reported that many etiologies play a role (vascular injury, orbital fracture, muscle rupture, head and face injury, and nerve injury), but it is a less common type of strabismus [ 31 – 33 ]. Some eye diseases, such as chorioretinal atrophy, congenital cataract, optic atrophy, retinal disease, complicated cataract, leukoma, coloboma, high myopia, congenital glaucoma, penetrating trauma, contusional eye trauma, and traumatic cataract cause visual impairment and may lead to strabismus by resulting in suppression [ 34 , 35 ]. In our study, the number of strabismus cases with epilepsy was 38 (9.7%), the number of those associated with trauma was 4 (1%), and the number of those associated with other ocular disorders was 14 (3.6%).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Clinical Characteristics and Risk Factors of Strabismus Cases

Yetkin¹

2023

North Clin Istanbul

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OBJECTIVE Strabismus, defined as the misalignment of the eyes, is a common disorder that is usually diagnosed in childhood. Strabismus is an important health problem with both functional and psychosocial effects on children. In this study, we aimed to determine the clinical features and risk factors of patients diagnosed with strabismus and followed up in our clinic. METHODS The data of pediatric patients who were followed up in our strabismus clinic between February 2016 and September 2022 were retrospectively reviewed. The patients’ detailed ophthalmological and strabismus examination findings and anamnesis findings concerning the etiology of strabismus were recorded. RESULTS A total of 391 patients were enrolled in the study. The mean age of the patients was 8.66±4.7 years. Of the patients, 207 (52.9%) had esotropia, 172 (43.99%) had exotropia, and 12 (3.07%) had vertical deviation, with the mean ages of these groups being calculated as (7.27±4.1), (10.45±4.8), and (7.16±4.7) years, respectively. Amblyopia was present in 54 (26.09%) of the 207 esotropia cases, 27 (15.70%) of the 172 exotropia cases. Esotropia is more likely than exotropia to be related to amblyopia, according to our research. Of all the patients, 97 (24.81%) had a family history of strabismus, 38 (9.7%) had a history of preterm birth, 39 (10.0%) had a history of neonatal care unit stay, 38 (9.7%) had epilepsy, 4 (1%) had a history of trauma, and 14 (3.6%) had an additional eye disease. CONCLUSION Detection of risk factors such as family history, preterm birth, length of stay in the neonatal care unit and epilepsy that may be associated with strabismus can help identify high-risk children for early diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Clinical Characteristics and Risk Factors of Strabismus Cases

Yetkin¹

2023

North Clin Istanbul

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“…There are few reports of exotropia with keratoconus but no case of PMD has been reported to present with ocular deviation. Ciftci et al 7 reported a case of a boy of 17 years with advanced keratoconus, BCVA of 1/60, and exotropia of the eye. Sherafat et al 6 evaluated 350 patients with keratoconus and found that 20 of them had abnormal binocular function.…”

Section: Discussionmentioning

confidence: 99%

“… 6 Sensory strabismus is a less common form of strabismus, the prevalence of which has been reported to be 5−9%. 7 Temporary or permanent loss of vision in one or both eyes can lead to sensory strabismus. We report a case of PMD and sensory exotropia in the background of VKC.…”

Section: Introductionmentioning

confidence: 99%

<p>A Teenager with Vernal Keratoconjunctivitis and Pellucid Marginal Degeneration, Presenting with Exotropia</p>

Bajracharya¹,

Agrawal²,

Dhungel³

et al. 2020

IMCRJ

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Background Vernal keratoconjunctivitis (VKC), an allergic disease, has a known association with ectatic disorders of the cornea. Pellucid marginal degeneration (PMD) is a bilateral, asymmetrical, ectatic disorder of the cornea characterized by inferior corneal thinning. We report a case of sensory exotropia due to PMD in association with VKC. Case Details A 19-year old boy with a history of VKC presented with exotropia of the right eye of 3 years’ duration. His unaided vision in his right eye was 1/60 and in his left eye it was 6/36. On examination, both eyes had high against the rule astigmatism, which was more in the right eye. There was exotropia of 15º (40 prism diopter base in) in the right eye with suppression (Worth four dot test). Corneal examination in both eyes showed inferior band thinning, 2 mm above the inferior limbus, extending from 4 to 8 clock hours, with bulging of the cornea just above the thinning. The clinical features were suggestive of PMD, which was supported by his corneal scans – Atlas, Pentacam, and Optovue. Although he was undergoing treatment for VKC, the onset of PMD and decrease in vision went unnoticed. The asymmetric error which was not corrected during the sensitive period of visual development led to sensory exotropia. Conclusion A child with VKC should undergo regular refraction so as not to miss any ectatic changes occurring in the cornea. A delay in diagnosing corneal ectasia may negate the possibility of collagen cross-linking which prevents progression of ectasia. If visual rehabilitation is delayed beyond the age of visual maturation, it can lead to strabismus, suppression, and loss of binocular function.

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Surgical Outcome of Sensory Exotropia with Distant-Near Disparity

Won

Kim

Lim

2015

J Korean Ophthalmol Soc

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Purpose:To assess clinical features of sensory exotropia with distant-near disparity, surgical outcome, and compare according to amount of medical rectus resection. Methods: Authors retrospectively reviewed medical records of patients of sensory exotropia with follow-up over 6 months. We defined patients with over 10 prism diopter (PD) disparity as distant-near disparity sensory exotropia (DND-XT) and without disparity as basic sensory exotropia (B-XT). First, we analyzed and compared data of visual acuity, cause and age of visual loss, amount of deviation. Second, Surgical failure was analyzed with dividing DND-XT into conventional surgery group as Parks' formula and reduced medial rectus resection group in accordance with disparity. Surgical success was defined as less than 10 PD deviation in distant, near fixation. Results: B-XT consisted of 58 patients (40 males) and DND-XT of 33 patient (13 males). There was no significant difference between 2 groups in onset and cause of visual loss, deviation at distant fixation. But, log MAR visual acuity of worse eye was better in DND-XT than B-XT (1.74 ± 0.78, vs. 2.10 ± 0.74, p = 0.039). Average deviation in distant fixation in DND-XT was 46.55 ± 16.59 PD in distant and 14.93 ± 8.91 PD in near fixation. All patients underwent surgery of medial rectus resection and lateral rectus recession and average deviation was 6.83 ± 7.71 PD at distant fixation, 3.02 ± 0.69 PD at near fixation at last follow-up. Among 33 patients, 16 patients underwent conventional amount of surgery and 17 patients with reduced medial rectus resection. In patient with conventional surgery, 9 patients were surgical failure (8 patients of over-, 1 patient of under-correction) but in patient with reduced amount of resection, only 1 patient was under-correction. Conclusions: As a result of medial rectus resection and lateral rectus recession in DND-XT, more surgical failures due to over-correction were observed with conventional resection and higher surgical success was attained in consideration of disparity.

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Sensory exotropia due to keratoconus and review of the literature

Cited by 3 publications

References 11 publications

Evaluation of Clinical Characteristics and Risk Factors of Strabismus Cases

Evaluation of Clinical Characteristics and Risk Factors of Strabismus Cases

<p>A Teenager with Vernal Keratoconjunctivitis and Pellucid Marginal Degeneration, Presenting with Exotropia</p>

Surgical Outcome of Sensory Exotropia with Distant-Near Disparity

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