Related Experiment Videos
The variable clinical characteristics and course of early infantile esotropia
1Department of Ophthalmology, Children's Hospital, Boston, Massachusetts 02115.
Insights
Early infantile esotropia management varied, with surgery improving binocularity in younger children. Some patients achieved alignment without surgery, but stable outcomes required ongoing observation.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
Background:
- Early infantile esotropia presents diverse clinical findings.
- Management strategies for infantile esotropia are varied.
- Neurologic impairment and prematurity can be associated with infantile esotropia.
Purpose of the Study:
- To analyze clinical findings and treatment outcomes for early infantile esotropia.
- To evaluate the impact of surgical timing on binocularity.
- To identify factors influencing alignment stability in treated esotropia.
Main Methods:
- Retrospective chart review of 75 patients with early infantile esotropia treated between 1965 and 1980.
- Analysis of treatment modalities including occlusion, glasses, and surgical intervention.
- Assessment of binocularity and alignment stability post-treatment.
Main Results:
- 75% of patients required glasses; refractive errors were common.
- 56 patients underwent surgery, while 19 achieved spontaneous alignment.
- Surgical alignment before age 2 yielded higher rates of binocularity (50%) compared to later surgery (14%).
- Binocularity did not guarantee stable alignment post-treatment.
Conclusions:
- Treatment for early infantile esotropia is highly individualized.
- Early surgical intervention may enhance the potential for binocularity.
- Spontaneous alignment can occur, and ongoing monitoring is crucial for all patients.
Abstract:
A study of 75 patients with early infantile esotropia treated by one of the authors (RMR) between 1965 and 1980 revealed a broad range of clinical findings and treatment modalities. The study group included nine children born prematurely and 16 with neurologic impairment; the balance had no apparent illness other than strabismus. Only 21 patients had spontaneously alternating fixation; the rest required some form of occlusion therapy. Glasses were prescribed for 75% of the patients sometime during their management, and changes in refractive error were common. One or more operations were performed on 56 patients, but 19 patients required no surgical intervention because of a spontaneous decrease in their deviation. Binocularity was found more frequently in patients straightened surgically before 2 years (50%) than in those straightened after that time (14%), but it was also present in five of the 19 patients who required no surgery. The presence of binocularity during the course of treatment did not insure stability of alignment.