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Sensory strabismus--eso or exo?

S A Havertape1, O A Cruz, F C Chu

  • 1Saint Louis University Health Sciences Center, Missouri, USA.

Journal of Pediatric Ophthalmology and Strabismus
|January 5, 2002
PubMed
Summary

Age at vision loss significantly impacts strabismus type. Congenital vision loss often leads to esotropia, while acquired vision loss is more likely to result in exotropia in sensory strabismus patients.

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Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Neuro-ophthalmology

Background:

  • Sensory strabismus, a condition involving misalignment of the eyes, is often associated with vision impairment.
  • The type of horizontal strabismus (esotropia or exotropia) is hypothesized to be influenced by the patient's age when vision loss occurs.

Purpose of the Study:

  • To determine the association between the age of vision loss onset and the subsequent development of esotropia versus exotropia in patients with sensory strabismus.

Main Methods:

  • A retrospective review of 123 patients diagnosed with sensory strabismus or conditions leading to it was conducted.
  • Data collected included age at vision loss onset and the type of horizontal strabismus (esotropia or exotropia).
  • Patients with unclear age of onset were excluded from the analysis.

Main Results:

  • Among 123 patients, 61% had congenital vision loss and 39% had acquired vision loss.
  • Patients with congenital vision loss were more likely to develop esotropia (67%) than exotropia (33%).
  • Conversely, patients with acquired vision loss predominantly developed exotropia (90%) compared to esotropia (10%). A significant association was found between age at onset and strabismus type (X²=37.44, P<.0001).

Conclusions:

  • Congenital vision loss is significantly linked to a higher incidence of sensory esotropia (P<.005).
  • Acquired vision loss shows a significant association with the development of sensory exotropia (P<.001).
  • The age of vision loss onset is a critical factor in predicting the type of horizontal strabismus in sensory strabismus.

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