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Sensory exotropia versus sensory esotropia: A comparative clinical features study
Mohammad Reza Akbari1, Alaa Alghurab2, Masoud Khorrami-Nejad3
1Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Journal of Optometry
|April 25, 2024
Summary
Sensory exotropia (XT) is more common than sensory esotropia (ET). Patients with sensory ET often have better visual acuity and a higher deviation angle, but nearly 40% of sensory strabismus patients require reoperation.
Area of Science:
- Ophthalmology
- Strabismology
- Pediatric Ophthalmology
Background:
- Sensory strabismus, characterized by misalignment of the eyes due to poor vision in one eye, includes both esotropia (ET) and exotropia (XT).
- Understanding the distinct clinical features of sensory ET and XT is crucial for effective diagnosis and management.
Purpose of the Study:
- To compare the preoperative clinical characteristics of patients diagnosed with sensory esotropia (ET) versus sensory exotropia (XT).
Main Methods:
- A retrospective review of 13,252 strabismus surgery patients from 2012 to 2022.
- Analysis focused on 1017 patients with sensory horizontal strabismus and corrected distance visual acuity (CDVA) of 20/160 or worse in the worse eye.
Main Results:
- Sensory XT (70.5%) was significantly more prevalent than sensory ET (29.5%).
- Patients with sensory XT exhibited worse CDVA in strabismic eyes compared to sensory ET patients.
- Sensory ET patients were more hyperopic, had higher angles of deviation, and were operated at a younger age than those with sensory XT.
- Moderate and severe amblyopia affected 26.9% and 71.5% of patients, respectively, with 39.1% requiring multiple surgeries.
Conclusions:
- Sensory XT occurs approximately 2.5 times more frequently than sensory ET.
- Preoperative differences in CDVA, refractive error, age at surgery, and deviation angle exist between sensory ET and XT.
- A substantial proportion (around 40%) of patients with sensory strabismus may require reoperation.
