Profile of infantile strabismus at a tertiary eye care center in India
Mariya Bashir Doctor1, Virender Sachadeva2, Ramesh Kekunnaya1
1Child Sight Institute, Jasti V Ramanamma Children's Eye Care Centre, Kallam Anji Reddy Campus, L. V. Prasad Eye Institute, Hyderabad, Telangana State, India.
Insights
Infantile strabismus affects 2.6% of infants, with esotropia being more common. Identifying risk factors and early surgical intervention are key for developing good binocular vision.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismology
Background:
- Infantile strabismus is a common condition affecting binocular vision in infants.
- Early identification of risk factors and timely management are crucial for optimal outcomes.
Purpose of the Study:
- To investigate the prevalence, risk factors, and management outcomes of infantile strabismus.
- To analyze the characteristics of strabismus in infants presenting at a tertiary eye care center.
Main Methods:
- Prospective analysis of infant data (age < 1 year) over 18 months.
- Comprehensive ophthalmological examinations and detailed history collection.
- Exclusion of infants with less than 6 months of follow-up.
Main Results:
- Hospital prevalence of infantile strabismus was 2.6% (123/4773 infants).
- Esotropia (62 cases) was more common than exotropia (37 cases).
- Identified risk factors include prematurity, hypermetropia, anisometropia for esotropia; C-section, delayed cry, seizures, consanguinity, developmental delay, myopia for exotropia.
- Surgical correction in 29 patients significantly reduced ocular deviation (P < 0.0001).
Conclusions:
- Infantile strabismus has a prevalence of 2.6%, with esotropia being twice as common as exotropia.
- Key risk factors for strabismus development in infancy were identified.
- Early surgical intervention in infantile strabismus promotes the development of binocular vision.
Purpose:
To study the profile, risk factors, and management outcomes of infantile strabismus at a tertiary eye care center.
Methods:
We prospectively analyzed the data of infants (children less than 1 year of age) who presented at our institute from August 2018 to December 2019. We excluded infants who did not complete a minimum follow-up of 6 months. Detailed meticulous history based on a set of standardized questionnaires was obtained and a comprehensive ophthalmological examination of the child was performed. Data were collected regarding refractive error (astigmatism; myopia; hyperopia; anisometropia [<1.0 DS or >1.0 DS]; astigmatism [<1.0 DS or >1.0 DS]) and the type of strabismus.
Results:
During this period, we saw 4,773 infants, out of which 123 infants were diagnosed to have infantile-onset strabismus (hospital prevalence of 2.6%). Boys and girls were equally affected. Sixty-two patients had esotropia, 37 had exotropia, 2 had hypotropia, and 22 had pseudo strabismus. Prematurity, hypermetropia, and anisometropia had increased odds of developing esotropia, whereas delivery by cesarean section, delayed cry at birth, infantile seizures, parental consanguinity, delayed development of milestones, and myopia had increased odds of developing exotropia. Twenty-nine patients underwent a surgical correction. The mean deviation at the first visit was 42.59 ± 15.40 PD and 8.25 ± 12.70 PD at the last visit. For all patients who underwent a squint surgery, the change in ocular deviation was clinically and statistically significant (P-value <0.0001, paired t-test).
Conclusion:
The hospital prevalence of infantile strabismus in our cohort was found to be 2.6%. Our study suggests that esotropia is two-fold more common in our cohort as compared to exotropia. Further, our study highlights risk factors for the development of strabismus in infancy, which must be kept in mind and awareness must be created among pediatricians. Surgical correction should be considered early during the infantile period, because it may lead to promote the development of good binocular vision.
