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Visual and vestibular functioning, and age and surgery effects on postural control in healthy children with vertical
Sergio Zanini1, Claudia Cordaro2, Lucia Martucci2
1Scientific Institute, IRCCS Eugenio Medea, Udine, Italy.
Insights
Children with vertical strabismus show complex visual, vestibular, and postural control issues. Surgery did not consistently improve these functions, indicating a need for further research into strabismus pathophysiology.
Area of Science:
- Ophthalmology
- Neurology
- Pediatrics
Background:
- Vertical strabismus in children can impact visual and vestibular systems.
- Postural control is crucial for development and may be affected by strabismus.
Purpose of the Study:
- To investigate visual and vestibular function in children with vertical strabismus.
- To assess the influence of age and corrective surgery on postural control in this population.
Main Methods:
- A comparative case series of 30 children (4-13 years) with vertical strabismus.
- Evaluations included ophthalmological, vestibular, and posturography assessments.
- Participants were grouped by age and surgical status.
Main Results:
- Younger children exhibited more binocular vision and convergence disorders.
- Surgical intervention showed a lower prevalence of asymmetric vestibular-evoked potentials.
- Fewer posturographic abnormalities were noted in younger children; surgery effects were not consistently beneficial.
Conclusions:
- The complex interplay of factors affecting postural control in vertical strabismus requires further investigation.
- This study highlights the intricate nature of strabismus pathophysiology beyond simple eye alignment.
Purpose:
To describe visual and vestibular functioning and the effects of age and surgery effects on postural control in healthy children with vertical strabismus.
Design:
This is a comparative case series.
Methods:
We evaluated participants at the Scientific Institute Eugenio Medea during routine clinical activities. We enrolled 30 consecutive children/adolescents (age range 4-13 years) with isolated vertical strabismus, with and without corrective surgery. Participants were split into four subgroups according to age (4-8 years versus 9-13 years) and ocular surgery (surgery versus no surgery). The clinical protocol included ophthalmological, orthoptic, neurological, physiatrical, otolaryngological, and vestibular evaluations, and the instrumental protocol included ocular cyclotorsions assessment, posturography, and vestibular myogenic-evoked potentials. Main outcome measures of the study were the prevalence of study-relevant orthopedic, ocular, vestibular, and posturographic abnormalities.
Results:
Among the overall largely variable findings across patients' groups, we found some interesting trends: larger binocular vision and convergence disorders in younger children, smaller prevalence of asymmetric vestibular-evoked potentials in operated children, less posturographic abnormalities in younger children. No clear-cut beneficial effect of surgery was found on all clinical and instrumental parameters considered, despite good re-alignment of the eyes.
Conclusion:
The pathophysiology of postural control in vertical strabismus is extremely complex and above the potential of this study design and should be specifically addressed in deeper experimental studies.
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