Strabismus Surgery and Its Effect Upon Infant Development in Congenital Esotropia

Rogers, Gary L.; Chazan, Saralea E.; Fellows, Rae R.; Tsou, Brian H.

doi:10.1016/s0161-6420(82)34766-1

Cited by 65 publications

(34 citation statements)

References 2 publications

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“…15,16 Both studies had methodological limitations. Rogers et al 15 reported that, compared to children with normal alignment, patients with infantile esotropia showed greater rates of improvement on the Mental Development Index (MDI) of the Bayley Scale of Infant Development. Yet this study is limited by its small sample size (18 patients; 8 control children) and its failure to match the ages of the control group to patients with infantile esotropia.…”

Section: Discussionmentioning

confidence: 99%

“…To date, only two small sample studies have investigated this possibility, with mixed results. 15,16 In the present study, we assess whether infantile esotropia delays the achievement of developmental milestones, and investigate the potentially beneficial effects of early surgery on subsequent motor development in a large sample of patients. To address these issues, the parents of children with infantile esotropia completed the Infant Developmental Skills Survey (IDSS), a new questionnaire developed and validated (see Appendix, published electronically) at the Retina Foundation of the Southwest (Morale & Birch, 2002).…”

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Improvement in motor development following surgery for infantile esotropia

Drover

Stager

Morale

et al. 2008

Journal of American Association for Pediatric Ophthalmology and

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Purpose-Infantile esotropia is associated with abnormal visual development and thus may delay the achievement of developmental milestones. Although early surgery can improve visual function, less is known about its effect on motor development. Here we address whether early surgery can improve motor development.Methods-Recently, our lab devised the Infant Developmental Skills Survey, a 25-item questionnaire designed to assess sensorimotor and gross motor development. The questionnaire was completed by the parents of 3-10 month-old patients with infantile esotropia prior to surgery (N = 143) and the parents of 6-11 month-old patients following surgery (N = 58). A subset of parents (N = 40) completed the questionnaire both before and after surgery. For comparison, the questionnaire was completed by the parents of infants with normal ocular alignment (N = 194).Results-Before surgery, 4, 5, 6, 7, 9 and 10 month-old patients showed delayed achievement of sensorimotor milestones (p < 0.01) and 5, 9 and 10 month-old patients demonstrated delayed attainment of gross motor milestones (p < 0.05) compared to normal children. However, following surgery, patients demonstrated a greater rate of sensorimotor development than age-matched controls (p<0.0001) and caught up with normal children on both sensorimotor and gross motor skills.Conclusions-Prior to surgery, patients with infantile esotropia were delayed in their achievement of developmental milestones. However, following surgery, a comparison group of patients showed rapid development and possessed motor skills comparable to those of normal children, suggesting that early surgery is beneficial to both visual and motor development.It is widely accepted that infantile esotropia is associated with severe deficits of stereopsis and fusion. 1,2 Given the normal rapid development of stereopsis and fusion between 3 and 8 months of age, 3-5 it is possible that infantile esotropia negatively impacts the achievement of early developmental motor milestones (grasping objects, walking, and crawling) which rely, at least to an extent, on normal visual development. 6 Poor stereoacuity has been shown to impede motor skills in older children. Recently, in a study of preschoolers investigating the effects of unilateral visual impairment, Hrisos et al. 7 found that reduced stereoacuity is associated with poor performance on tasks assessing hand-eye coordination and visuomotor skills. 7The visual outcomes of patients with infantile esotropia are substantially improved if the misalignment is corrected surgically early in life. Recent reports suggest that early muscle surgery is associated with greater prevalence of stereopsis and fusion along with reducedThe authors have no commercial interest Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is p...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Improvement in motor development following surgery for infantile esotropia

Drover

Stager

Morale

et al. 2008

Journal of American Association for Pediatric Ophthalmology and

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“…9,10,11,12,13,14,15,16 In a comparative study on quality of life of strabismic and non-strabiscmic visually normal adults, there was statistically significant difference in the overall score, psychosocial score as well as function score (p value 0.00). 17 Improvement in ocular alignment and restoration of sensory status occurs after surgical treatment of adult strabismus.…”

Section: Discussionmentioning

confidence: 98%

Quality of Life of Adults Before and After Strabismus Surgery at a Tertiary Care Eye Centre of Kathmandu, Nepal

Shrestha

Manoranjan²,

Shrestha

2017

Med. J. Shree Birendra Hosp.

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Introduction: Strabismus affects the quality of life of adults both in functional and psychosocial aspect of life. This study was conducted to compare the health related quality of life in adults before and after strabismus surgery. Methods: It was a prospective quantitative study conducted in Nepal Eye Hospital from Sep 2015 to July 2016.Thirty one adult participants with strabismus undergoing strabismus surgery completed the study. Twenty open ended adult strabismus questionnaire (AS-20) were used to assess the health related quality of life of adults before and one month after strabismus surgery. Results: The overall median score of adult strabismus questionnaire for quality of life improved from 68.75 (Interquartile range (IQR 25) to 91.25 (IQR 17.5) after strabismus surgery (p value < 0.00). Similarly, the median function subscale and median psychosocial subscale also improved from 72 (IQR 25) to 95 (10) and from 55 (IQR 37.5) to 90 (IQR 15) respectively after surgery. Conclusion:The quality of life of adult strabismic patients improved significantly after stabismus surgery.

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“…Strabismus surgery in childhood during the period of cortical plasticity can restore binocular single vision and stereopsis. Rogers et al reported an improvement in Þ ne motor skills in 35% of children with congenital esotropia after early surgery 7 .…”

Section: Discussionmentioning

confidence: 99%

“…Apart from cosmesis, the three major reasons to correct adult strabismus are restoration of binocular fusion and elimination of diplopia, expansion of binocular visual Þ eld in patient with esotropia 6 and improvement in psychsocial functioning 7 .…”

Section: Discussionmentioning

confidence: 99%

Surgical outcome of strabismus

Shrestha

2015

Med. J. Shree Birendra Hosp.

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Introduction: Strabismus is encountered daily by paediatric ophthalmologists and orthoptists in their practice. Strabismus and amblyopia affect 5% of the population. The aim of the study was to determine the surgical outcome of strabismus.Methods: It was a prospective study conducted at Nepal Eye Hospital from 2010 to 2011 with the sample size of 40. Patients undergoing strabismus surgery either for esotropia or exotropia were included in the study. Detailed preoperative and postoperative orthoptic evaluation of all the patients was done apart from the anterior and posterior segment examination and the surgical outcome was assessed.Results: Forty patients of which 52.5% males and 47.5% females with mean age of 21.025 years underwent strabismus surgery. Manifest divergent squint was present in 61%, manifest convergent squint in 38% and intermittent squint in 5% of patients. 87.5% underwent 2 muscle surgery, 10% underwent 3 muscle surgery and 2.5% underwent single muscle surgery. Postoperative deviation for near was 0 in 10%, 2-8 in 37.5% and 10-15 in 27.5%. Similarly, postoperative deviation for distance was 0 in 22%, 2-8 in 27% and 10-15 in 22%. Binocular single vision was present in 50% patients preoperatively and 53% patients postoperatively. Conclusion:Though cosmesis has been improved in most of the patients after strabismus surgery, binocular single vision and stereopsis improved in very minimal percentage of patients as the surgery was done after the age of visual maturation in most of the cases. This accentuates the need for strabismus surgery within the years of cortical plasticity.Keywords: amblyopia, binocular single vision, strabismus, surgical outcome. Strabismus and amblyopia affect 5% of the population. The aim of the study was to determine the surgical outcome of strabismus. Surgical outcome of strabismusMethods: It was a prospective study conducted at Nepal Eye Hospital from 2010 to 2011 with the sample size of 40. Patients undergoing strabismus surgery either for esotropia or exotropia were included in the study. Detailed preoperative and postoperative orthoptic evaluation of all the patients was done apart from the anterior and posterior segment examination and the surgical outcome was assessed.Results: Forty patients of which 52.5% males and 47.5% females with mean age of 21.025 years underwent strabismus surgery. Manifest divergent squint was present in 61%, manifest convergent squint in 38% and intermittent squint in 5% of patients. 87.5% underwent 2 muscle surgery, 10% underwent 3 muscle surgery and 2.5% underwent single muscle surgery. Postoperative deviation for near was 0 in 10%, 2-8 in 37.5% and 10-15 in 27.5%. Similarly, postoperative deviation for distance was 0 in 22%, 2-8 in 27% and 10-15 in 22%. Binocular single vision was present in 50% patients preoperatively and 53% patients postoperatively.Conclusions: Though cosmesis has been improved in most of the patients after strabismus surgery, binocular single vision and stereopsis improved in very minimal percentage of patient...

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Strabismus Surgery and Its Effect Upon Infant Development in Congenital Esotropia

Cited by 65 publications

References 2 publications

Improvement in motor development following surgery for infantile esotropia

Improvement in motor development following surgery for infantile esotropia

Quality of Life of Adults Before and After Strabismus Surgery at a Tertiary Care Eye Centre of Kathmandu, Nepal

Surgical outcome of strabismus

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