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Introduction: Accomodative esotropia is secondary to inappropriate convergence during accomodative effort in an uncorrected hyperope and is often familial.
Case presentation: we report the case of 20 year old Caucasian patient with congenital esotropia alternating, of 30 prism diopters distance (5 m) and 40 prism diopters of esotropia at near, in b...
Context in source publication
Context 1
... of the local Ethics Committee and written informed patient consent were obtained for this study. A 20 year old Caucasian patient affect by with congenital esotropia alternating non accommodative esotropia, that developed by 6 months of age Fig.1. He has never been subject to surgical correction of his strabismus. ...
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Study design:
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Objective:
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Setting:
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Methods:
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Citations
... Some studies report, regardless of the presence of ROP, persistent visual acuity deficits in preterm infants, even into adulthood, secondary to damage to the retinal cones to prolonged phototherapy for the treatment of jaundice (13)(14)(15), the same result was shown in 19.9% of the patients examined in our study with amblyopia (11/57) who had undergone the aforementioned treatment for more than one month (16,17). ...
... In view of the therapeutic successes achieved in the treatment of the pathologies highlighted in these young patients, from the treatment of ROP, amblyopia, strabismus to refractive defects, it follows that prevention and early diagnosis are two indispensable aspects, especially in the preverbal and pre-school age, to allow adequate recovery of visual function and inclusion in society with greater educational possibilities for the child (1,15). Otherwise, if not diagnosed and treated in good time, it could have negative repercussions during the various stages of development, especially in the school age of learning (1,2,22,23). ...
Objective:
Prematurity often results in important developmental sequelae of brain structures, particularly those involved in processing visual information, such as the optic nerve, primary visual cortex and visuomotor integration areas. The aim of this study is to analyse the functionality of the sensory and motor pathways of the visual system by means of an orthoptic-ophthalmological assessment.
Materials and methods:
In this retrospective study, 151 records were examined, covering a period from 2000 to 2020, of preterm patients with gestational age < 32 weeks and birth weight ≤ 1,500 g up to an average age of about 8 years, referred to the Centre for Paediatric Ophthalmology and Strabology of the Ophthalmology Clinic of the Policlinico Umberto I, La Sapienza University of Rome, who underwent a complete ophthalmological and orthoptic assessment including the following tests measurement of ocular deviations according to the Hirschberg method, Lang I-II test, Titmus Stereotest, objective convergence assessment and ocular motility examination.
Results:
From the charts reviewed, 24.5% (37/151) of patients had Retinopathy of the Premature (ROP); while 38% of the whole sample (57/151) had strabismic amblyopia, of the latter only 31.5% (18/57) had ROP. In 8% of patients (12/151) the stereoscopic sense was absent, in 45% (8/151) stereopsis was gross (> 60 seconds of arc). In addition, 20.52 % (31/151) had a manifest eye deviation. 7.28% (11/151) had hypermetropia in the right eye (RE); 7.95% (12/151) hypermetropia in the left eye (OS); 3.31% of the patients (5/151) had myopia in the RE; 2% (3/151), myopia in the left eye (LE). In addition, the study of ocular motility revealed varying degrees of alteration poorly correlated with prematurity status.
Conclusion:
It was found that amblyopia, stereopsis and objective convergence are more affected by ROP than strabismus, refractive defects and ocular motility, indicating that premature children are particularly susceptible to ophthalmological and orthoptical alterations.
... Success in amblyopia treatment also translates into better quality of live 39 and higher self-confidence of the patients as well as into an improved cost-benefit ratio. 40,41 ...
Purpose:
Outcomes Research Study on patients suffering from anisometropia or isoametropia associated with amblyopia and microstrabismus to show the impact of late occlusion treatment on therapeutic prognosis.
Materials and methods:
Enrollment of all the eligible patients presenting to recruiting centers at the Department of Pediatric Ophthalmology and Strabismus - Ophthalmological Clinic - Policlinico Umberto I - Rome. At baseline, all patients will undergo an opthalmologic evaluation. Recruited patients will be followed for a 2-year period. Our test group was composed of 31 patients, 11 with bilateral and 20 with monolateral amblyopia, totalling 42 amblyopic eyes, and it was assessed - always by the same examiner - with the help of the following orthoptic examinations: Wirt test, Irvine-Jampolsky test (4 dioptre fixation task), Visuscope, Cover Test, Bagolini striated glasses, and Worth lights test. We assessed pre-post treatment variations observed in the overall group of amblyopic eyes, regardless of the differences between RE and LE.
Outcomes:
Of the 31 children, 58.1% were males and 41.9% female, average age between 6 and 14 years. Of the 42 amblyopic eyes, after daily occlusion of 8 hours ± 2.30 SD, we recorded an improvement of 71.4%, and visual acuity increased from an average of 0.4 LogMAR to 0.1 LogMAR.
Conclusion:
Late anti-amblyopic occlusion treatment proved effective in the long term for children 6 to 12 years, specifically regarding visual acuity, fixation, stereopsis, and binocular collaboration in patients suffering from anisometropia or isoametropia and microstrabismus.
