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Exotropia in children with high hyperopia

Iris S Kassem1, Steven E Rubin, Sylvia R Kodsi

  • 1Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|October 23, 2012
PubMed

Insights

Children with high hyperopia and exotropia often have developmental delays and amblyopia. Full correction of high hyperopia with spectacles can significantly improve exotropia alignment in these pediatric patients.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Strabismus

Background:

  • Exotropia and high hyperopia are common conditions in pediatric ophthalmology.
  • Associated developmental delays and amblyopia are frequently observed in children with these conditions.

Purpose of the Study:

  • To characterize the clinical presentation, management strategies, and outcomes for children diagnosed with exotropia and high hyperopia.
  • To evaluate the effectiveness of spectacle correction in managing exotropia associated with high hyperopia.

Main Methods:

  • Retrospective review of medical records for 26 pediatric patients with exotropia and hyperopia (≥4.00 D) between 1990 and 2009.
  • Analysis of patient demographics, clinical findings, treatments administered (spectacle correction, surgery), and alignment outcomes.

Main Results:

  • 15 out of 26 patients had co-occurring medical conditions or developmental delays.
  • 19 out of 22 patients with measured visual acuity had amblyopia (unilateral or bilateral); none demonstrated fine stereoacuity.
  • Full spectacle correction of hyperopia improved exotropia in 10 out of 15 patients; partial correction improved it in 3 out of 8 patients. Six patients required strabismus surgery.

Conclusions:

  • Pediatric patients with high hyperopia and exotropia frequently present with developmental issues, systemic diseases, amblyopia, and impaired stereopsis.
  • Comprehensive correction of high hyperopia using full cycloplegic refraction in exotropic children can lead to substantial improvements in ocular alignment.
Abstract

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