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Published on: April 28, 2020
Prevalence of horizontal deviation pattern changes with measurements in extreme gazes
1Department of Strabismus, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil. eprocianoy@ terra.com.br
Purpose:
To analyse the difference between measurement of A and V pattern strabismus at 25 degrees and extreme gaze position in esotropia (ET) and exotropia (XT).
Methods:
This prospective cross-section study included 27 patients with basic horizontal strabismus associated to any deviation pattern. Mean age was 11.88+/-9.17 (6-44) years. Exclusion criteria were amblyopia, intermittent XT, noncollaboration with the exam, previous strabismus surgery, craniofacial, or spinal abnormalities. The deviations were measured with prism cover test at 6 m. Measurements were carried out in primary position, upgaze (neck flexion of 25 degrees and maximum flexion) and downgaze (neck extension of 25 degrees and maximum extension). A goniometer with a bubble level controlled the neck position.
Results:
The most significant changes were in downgaze. The pattern size increased 4 prism dioptres (PD) or more in 56.25% of the V- and in 87.5% of the A-patterns. The mean increase was 8.00+/-6.04 PD (0-17 PD) for the A-pattern ET, 4.80+/-3.70 PD (0-10 PD) for the V-pattern XT, and 6.50+/-5.58 PD (0-15 PD) for the V-pattern XT. The only case of A-pattern XT increased 8 PD.
Conclusion:
Our results suggest that measurements in extreme up and downgazes may uncover increased deviations in a significant proportion of cases. Further studies remain necessary to determine the relevance of these findings for strabismus correction.
