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Published on: May 23, 2013
Dissociated vertical deviation in patients with intermittent exotropia.
Hyun Taek Lim1, David R Smith, Stephen P Kraft
1Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
Summary
Early strabismus onset and poor stereopsis are linked to dissociated vertical deviation (DVD) in intermittent exotropia. DVD in intermittent exotropia differs from infantile esotropia, showing smaller amounts and consistent responses to the Bielschowsky head-tilt test.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Research
Background:
- Dissociated vertical deviation (DVD) is a common strabismus anomaly.
- Intermittent exotropia (IXT) is a frequently encountered form of strabismus in children.
- Understanding factors contributing to DVD development in IXT is crucial for effective management.
Purpose of the Study:
- To investigate the relationship between strabismus onset age and stereopsis with DVD development in intermittent exotropia patients.
- To characterize the features of DVD in patients with intermittent exotropia and compare them to those with infantile esotropia.
Main Methods:
- Retrospective review of patient records categorized into three groups: IXT with DVD, infantile esotropia with DVD, and IXT without DVD.
- Comparison of age at strabismus onset, stereopsis, strabismus measurements, and DVD response to the Bielschowsky head-tilt test across groups.
Main Results:
- Fifty-two children with IXT and DVD were identified.
- Patients with IXT and DVD had an earlier strabismus onset (12.7 months) and worse stereopsis (147 arcsec) compared to IXT without DVD (28.9 months, 65 arcsec).
- DVD amount was smaller in IXT with DVD (9.7 prism diopters) than in infantile esotropia with DVD (17.2 prism diopters), with 91% showing increased DVD on ipsilateral head tilt.
Conclusions:
- Earlier strabismus onset and poorer stereopsis are associated with the development of DVD in intermittent exotropia.
- DVD in intermittent exotropia presents with distinct characteristics compared to infantile esotropia, including smaller magnitude and more consistent responses to the Bielschowsky head-tilt test.
