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Developmental evaluation in congenital esotropia

M B Wheeler, K Stonesifer, M Kenny

    Ophthalmology
    |December 1, 1979
    PubMed
    Summary
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    Congenital esotropia surgery did not significantly alter developmental scores in infants. Most patients showed persistent developmental delays or normal scores on the Bayley Scales of Infant Development (BSID) post-surgery.

    Area of Science:

    • Ophthalmology
    • Developmental Pediatrics

    Background:

    • Congenital esotropia is a common form of strabismus in infants.
    • Surgical correction aims to improve eye alignment and potentially visual development.

    Purpose of the Study:

    • To evaluate the impact of surgical intervention for congenital esotropia on infant neurodevelopmental outcomes.
    • To assess changes in cognitive and motor skills using the Bayley Scales of Infant Development (BSID) before and after surgery.

    Main Methods:

    • Prospective study involving 11 infants with congenital esotropia.
    • Bayley Scales of Infant Development (BSID) administered pre-operatively and at 2 and 6 months post-operatively.
    • Surgical procedure: bilateral medial rectus muscle recessions.

    Main Results:

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    • Eight patients completed all assessments; no significant changes in BSID scores were observed between pre-operative and 6-month post-operative evaluations.
    • Developmental outcomes varied: 2/8 patients were normal, 3/8 had significant mental and motor delays, 1/8 had significant mental delay, and 1/8 had motor delay.
    • Six patients achieved orthophoria post-surgery; 4 required a second surgical procedure.

    Conclusions:

    • Surgical correction of congenital esotropia in this cohort did not lead to significant improvements in neurodevelopmental status as measured by the BSID.
    • Persistent developmental delays were noted in a substantial proportion of patients, suggesting that early surgical alignment may not fully address underlying neurodevelopmental challenges.