Related Experiment Video
Updated: Aug 16, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Strabismus in pediatric pseudophakia
Oren L Weisberg1, Derek T Sprunger, David A Plager
1Section of Pediatric Ophthalmology, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Insights
Strabismus is common in pediatric pseudophakia (39% of cases). Early detection and treatment of strabismus in these children can lead to successful alignment.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Research
Background:
- Pediatric pseudophakia, resulting from cataract extraction and intraocular lens implantation, presents unique challenges.
- The association between pediatric pseudophakia and strabismus requires further investigation.
Purpose of the Study:
- To evaluate the occurrence and characteristics of strabismus in pediatric patients with pseudophakia.
- To identify factors associated with strabismus development in this population.
Main Methods:
- Retrospective case series of 94 pediatric patients undergoing cataract extraction with intraocular lens implantation.
- Analysis of pre- and post-operative alignment measurements, visual acuity, and amblyopia data.
- Evaluation of strabismus surgery outcomes.
Main Results:
- Strabismus was identified in 39% of pediatric pseudophakia patients, with exotropia being more frequent than esotropia.
- Pre- and post-operative visual acuity, strabismus type, and post-operative amblyopia were statistically associated with strabismus development.
- Strabismus surgery achieved alignment in 75% of cases with a mean follow-up of 24 months.
Conclusions:
- Strabismus is more prevalent in pediatric pseudophakia than in the general pediatric population.
- Close monitoring for strabismus in pseudophakic children is crucial.
- Timely intervention for strabismus in this cohort can yield successful treatment outcomes.
Objective:
To evaluate strabismus associated with pediatric pseudophakia.
Design:
Retrospective case series.
Participants:
Charts of 94 pediatric patients who underwent cataract extraction with primary intraocular lens implantation from 1990 to 2003 at Indiana University School of Medicine were reviewed. Only those patients who had pre-cataract extraction and post-cataract extraction alignment measurements were included.
Methods:
Data were collected on gender, race, age at presentation, age at time of cataract surgery, and type of cataract. Pre-cataract extraction and post-cataract extraction data on visual acuity (VA), alignment, and amblyopia were recorded. Results of strabismus surgery were also evaluated.
Main Outcome Measures:
Frequency, type and amount of strabismus, and results of strabismus surgery.
Results:
Ninety-four pediatric pseudophakia patients were identified, and 37 (39%) had strabismus. Exotropia (46%) was more common than esotropia (41%). Factors not associated with the development of strabismus included age at presentation, interval between diagnosis and cataract extraction, race, and type of cataract. Factors statistically associated with the development of strabismus include pre-cataract extraction and post-cataract extraction VA, type of strabismus, and post-cataract extraction amblyopia. The mean pre-cataract extraction deviation of the group that had strabismus surgery was 22 prism diopters, and 75% were aligned at the last examination (mean follow up, 24 months).
Conclusion:
Strabismus occurs more frequently in pseudophakic pediatric patients than in the general pediatric population. Pseudophakic children should be monitored carefully for the development of strabismus, which in many cases can be successfully treated.
Related Concept Videos
01:16Focusing of Light in the Eye
01:28Angle Closure Glaucoma: Treatment