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Heroin and strabismus.

F K P Sutter1, Klara Landau

  • 1Department of Ophthalmology, University Hospital Zurich, Switzerland.

Swiss Medical Weekly
|July 5, 2003
PubMed
Summary
This summary is machine-generated.

Acute strabismus, including esotropia and exotropia, can occur with heroin withdrawal or intake. Neurological exams are often normal, but orthoptic referral aids symptomatic treatment during opioid addiction therapy.

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Area of Science:

  • Ophthalmology
  • Neurology
  • Addiction Medicine

Background:

  • Opioid use, including heroin and methadone, is associated with various systemic effects.
  • Ocular motility disorders, such as strabismus, can be a manifestation of substance use or withdrawal.

Observation:

  • This study retrospectively analyzed patients experiencing acute strabismus linked to heroin or methadone.
  • Five patients developed acute esotropia during heroin withdrawal; two developed exotropia related to heroin/methadone intake.

Findings:

  • Neurological work-up and neuroimaging were non-contributory in examined patients.
  • Acute esotropia with diplopia is a notable side effect of heroin withdrawal.
  • Acute exotropia may be associated with heroin intake.

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Implications:

  • In the absence of focal neurological signs, extensive work-up may not be mandatory.
  • Referral to specialized orthoptic services is recommended for symptomatic management and patient reassurance.
  • Addressing strabismus can support successful withdrawal therapy in patients with opioid use disorder.