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[Converging squint in severe hypermetropia (author's transl)].

E Stangler-Zuschrott

    Klinische Monatsblatter Fur Augenheilkunde
    |September 1, 1975
    PubMed
    Summary

    High hypermetropia increases primary microstrabismus in convergent squint cases. Spontaneous shifts to divergent squint occur, particularly with severe hypermetropia and increased ACA ratio.

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    [Disorders of eye movements in point fixation of the dominant eye in unilateral deprivation amblyopia, squint amblyopia and unilateral organ damage].

    Klinische Monatsblatter fur Augenheilkunde·1987

    Area of Science:

    • Ophthalmology
    • Pediatric Ophthalmology
    • Strabismology

    Background:

    • Convergent squint (esotropia) is frequently associated with hypermetropia.
    • The relationship between the degree of hypermetropia and the type of esotropia requires further elucidation.
    • Understanding these associations is crucial for effective management and prognosis.

    Purpose of the Study:

    • To investigate the correlation between the severity of hypermetropia and the prevalence of primary microstrabismus versus full-accommodative esotropia.
    • To identify factors associated with spontaneous changes from convergent to divergent squint.
    • To emphasize the importance of measuring the accommodation-convergence/accommodation (ACA) ratio.

    Main Methods:

    • Retrospective analysis of 541 cases of convergent squint with hypermetropia exceeding +5 diopters (D).
    • Categorization of strabismus into primary microstrabismus and full-accommodative strabismus convergens.
    • Observation of spontaneous squint angle changes and associated clinical factors.

    Main Results:

    • A positive correlation was found between higher degrees of hypermetropia and an increased proportion of primary microstrabismus.
    • In patients with hypermetropia > +8 D, primary microstrabismus constituted 46% of cases, often unilateral, increasing amblyopia risk.
    • 10% of cases showed spontaneous conversion from convergent to divergent squint, influenced by high hypermetropia (> +8 D), increased ACA ratio, unilateral exclusion, and vertical divergence.

    Conclusions:

    • High hypermetropia is a significant factor in the development of primary microstrabismus in convergent squint.
    • Spontaneous divergence after initial convergence is possible and influenced by specific clinical parameters.
    • Routine measurement of the ACA ratio during orthoptic examinations is recommended for comprehensive patient assessment.

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