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[Postoperativ binocular function after full prismatic correction in patients with concomitant convergent strabismus
Insights
Prolonged prismatic correction in children with convergent strabismus can lead to secondary exuberance of convergence. Secondary cases show a better long-term binocular function prognosis compared to primary cases.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismology
Context:
- Investigated 50 non-amblyopic children with concomitant convergent strabismus and convergence excess.
- Assessed outcomes of prolonged prismatic correction for strabismus management.
Purpose:
- To analyze the development and prognosis of primary versus secondary exuberance of convergence after prismatic correction.
- To evaluate the long-term binocular function following interventions for strabismus.
Summary:
- Prolonged prismatic correction was applied to 50 children with convergent strabismus.
- 19 patients developed secondary exuberance of convergence; their distance squint angle increased by less than 6 degrees or decreased.
- Primary exuberance of convergence cases had a worse long-term prognosis (4-5 years) for binocular function compared to secondary cases.
Impact:
- Highlights the distinction between primary and secondary convergence excess in strabismus.
- Provides insights into the long-term visual prognosis based on the type of convergence excess.
- Informs clinical decision-making regarding prismatic correction strategies in pediatric strabismus.
Abstract:
We investigated the cases of 50 non amblyopic children with concomitant convergent strabismus and exuberance of convergence, in which a prolonged prismatic correction was performed. 31 children had a 5 degree higher angle of squint in near vision before the application of prism. In 13 out of 31 the angle of squint, which was measured at the gaze for distance, increased more than 6 degrees. The ratio of normal retinal correspondence (NRC) to abnormal retinal correspondence (ARC) is 14:17. 19 patients developed only after prismatic correction of the angle of squint an exuberance of convergence. This phenomenon we call secundary exuberance of convergence. In this group the angle of squint for distance vision increased in only three children more than 6 degrees, while 6 children had a decrease by up to 11 degrees. The ratio NRC: ARC is 7:12. Postoperativ follow-up of binocular function over 4-5 years showed, that the prognosis in case of primary exuberance of convergence is worse than in secondary.