scholarly journals Efficacies of preoperative prism adaptation test and monocular occlusion for detecting the maximum angle of deviation in intermittent exotropia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ryota Takada ◽  
Fumiko Matsumoto ◽  
Akemi Wakayama ◽  
Takuya Numata ◽  
Fumi Tanabe ◽  
...  
Keyword(s):  
Strabismus Surgery ◽  
Prism Adaptation ◽  
Maximum Deviation ◽  
Test Duration ◽  
Intermittent Exotropia ◽  
Maximum Angle ◽  
Significant Difference ◽  
Adaptation Test ◽  
Angle Of Deviation ◽  
Distance Deviation

Abstract Background The efficacies of prism adaptation test (PAT) and monocular occlusion (MO) and their optimal test durations to detect the maximum angles of deviation at near and distance in eyes with intermittent exotropia (IXT) were assessed and compared. Methods We retrospectively reviewed the medical records of 72 patients with IXT. All the patients had undergone the initial strabismus surgery between April 2015 and October 2018 and had been preoperatively tested by both PAT and MO performed on different days for 30 and 60 min. Near and distance deviations after 30 and 60 min of PAT and MO were compared to their baseline measurements obtained immediately after prism wear and before occlusion by alternate prism cover test. The near/distance measurements and required test duration to reveal the maximum deviation angle were also compared between PAT and MO. Results Compared with the baseline, the near deviation by PAT significantly increased after 30 (P < 0.05) and 60 (P < 0.01) minutes but not the distance deviation. However, the increase after 30 min was not significant. By MO, neither near nor distance deviation showed a significant difference from the baseline after 30 and 60 min. PAT showed a significantly larger near deviation than MO at 30 and 60 min, but a larger distance deviation by PAT was only observed at 30 min. Conclusions In patients with basic and convergence insufficiency types of IXT, a 30-minute PAT appears to be more effective than MO in revealing the maximum angle of deviation before strabismus surgery.

scholarly journals Efficacies of preoperative prism adaptation test and monocular occlusion for detecting the maximum angle of deviation in intermittent exotropia

2021 ◽  
Author(s):  
Ryota Takada ◽  
Fumiko Matsumoto ◽  
Akemi Wakayama ◽  
Takuya Numata ◽  
Fumi Tanabe ◽  
...  
Keyword(s):  
Strabismus Surgery ◽  
Prism Adaptation ◽  
Maximum Deviation ◽  
Intermittent Exotropia ◽  
Optimal Test ◽  
Maximum Angle ◽  
Significant Difference ◽  
Adaptation Test ◽  
Angle Of Deviation ◽  
Distance Deviation

Abstract Purpose: The efficacies of prism adaptation test (PAT) and monocular occlusion (MO) and their optimal test durations to detect the maximum angles of deviation at near and distance in eyes with intermittent exotropia (IXT) were assessed and compared. Methods: We retrospectively reviewed the medical records of 72 patients with IXT, who had undergone the initial strabismus surgery between April 2015 and October 2018 and had been preoperatively tested by PAT and MO. The near and distance deviations measured after 30- and 60-minute PAT and MO were compared with the baseline measurements obtained immediately after prism wear and before occlusion. The measurements and the required durations for obtaining the maximum deviation angle were also compared between PAT and MO. Results: Compared with the baseline, the near deviation by PAT significantly increased after 30 (p < 0.05) and 60 (p < 0.01) minutes but not the distance deviation. Besides, the increase in the near deviation after 30 minutes was not significant. By MO, neither near nor distance deviation showed a significant difference from the baseline after 30 and 60 minutes. While the near deviations by PAT were significantly greater than those by MO at 30 and 60 minutes, a similar result was only observed at 30 minutes in the distance deviation. Conclusion: A 30-minute PAT appears to be more effective than MO in revealing the maximum angle of deviation before strabismus surgery.

Evaluation of ocular motility deviation changes in exotropic patients after cycloplegic eye drops versus prism adaptation test

2018 ◽  
Vol 29 (5) ◽  
pp. 482-485 ◽  
Author(s):  
Alon Zahavi ◽  
Ronit Friling ◽  
Yonina Ron ◽  
Miriam Ehrenberg ◽  
Yoav Nahum ◽  
...  
Keyword(s):  
Medical History ◽  
Statistical Significance ◽  
Strabismus Surgery ◽  
Prism Adaptation ◽  
Eye Drops ◽  
Ocular Motility ◽  
End Points ◽  
End Point ◽  
Significant Difference ◽  
Adaptation Test

Purpose:To evaluate changes in ocular motility deviation with cycloplegic eye drop examination compared to the prism adaptation test in patients with strabismus.Methods:The medical charts were reviewed of all patients who underwent primary strabismus surgery in our center from December 2013 to July 2015. Data collected included demographics, medical history, and findings on pre-operative ophthalmic/orthoptic examination. Ocular motility deviation was measured before instillation of cycloplegic eye drops, immediately after maximal dilation (end point), and 10 and 20 min later. Prism adaptation test readings were taken at baseline, immediately after prism removal (end point), and 10 and 20 min later.Results:A total of 43 patients had complete pre- and post-operative evaluations. Our analysis focused only on the exotropic patients (n = 33). On cycloplegics, there was no significant difference in ocular motility deviation between baseline and end point for distance and near (p = 0.584, p = 0.468, respectively). On prism adaptation test, comparison of ocular motility deviation between baseline and end point was statistically significant for distance and near (p = 0.002, p = 0.001, respectively). Changes remained significant 10 min after the end point for near (p = 0.011). Comparison at the end points between the tests revealed statistical significance for distance and near, favoring the prism adaptation test (p = 0.001 and p < 0.001, respectively). This significance was maintained even after 10 min for near (p = 0.036).Conclusion:The prism adaptation test is preferred over cycloplegic eye drops for the evaluation of maximal reserve of distance/near motility before surgical correction of exotropia.

scholarly journals Fusional Vergence Detected by Prism Bar and Synoptophore in Chinese Childhood Intermittent Exotropia

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Tao Fu ◽  
Jing Wang ◽  
Moran Levin ◽  
Qing Su ◽  
Dongguo Li ◽  
...  
Keyword(s):  
Break Point ◽  
Chinese Children ◽  
Intermittent Exotropia ◽  
Link Type ◽  
Control Score ◽  
Significant Difference ◽  
Angle Of Deviation ◽  
Break Points

Purpose. To measure the changes in fusional vergence in Chinese children with intermittent exotropia (IXT) and the association with the control of IXT.Methods. Ninety-two patients with IXT (8–15 years old) were compared with 86 controls. Exodeviation control was evaluated using the Revised Newcastle Control Score. Angle of deviation was measured using prism and alternate cover testing at distance and near. Fusional vergence was measured using prism bar and synoptophore. This study was registered withChiCTR-RCC-13003920.Results. Using prism bar, convergence break points were lower whereas divergence break points were higher in children with IXT at distance (P<0.001) and near (P<0.001) compared with controls. There was no significant difference in mean divergence amplitudes between the two groups when testing using a synoptophore (P=0.53). In children with IXT, the distance between recovery point and break point in both convergence (distance:P=0.02; near:P=0.02) and divergence (distance:P<0.001; near:P<0.001) was larger than controls when detected by prism bar and synoptophore (convergence:P=0.005; divergence:P=0.006).Conclusions. Children with IXT have reduced convergence amplitudes as detected by both prism bar and synoptophore.

The health-related quality of life and anxiety for childhood intermittent exotropia before and after surgical correction

2020 ◽  
Author(s):  
danyi mao ◽  
jing lin ◽  
lina chen ◽  
jiying luo ◽  
jianhua yan
Keyword(s):  
Quality Of Life ◽  
Strabismus Surgery ◽  
Health Related Quality ◽  
Intermittent Exotropia ◽  
Near Vision ◽  
Before And After ◽  
Related Quality ◽  
Health Related ◽  
Angle Of Deviation

Abstract Purposes:To assess the health-related quality of life (HRQOL) and hospital anxiety and depression scale (HADS) in Chinese children with intermittent exotropia (IXT) before and after strabismus surgery.Patients and Methods: The records of children with IXT who underwent strabismus surgery at the Zhongshan Ophthalmic Center, of Sun Yat-sen University, China over the period from January 1, 2016 to December 31, 2018 were retrospectively reviewed. All children underwent ophthalmic and orthoptic examinations including the prism and alternate cover test, fusion function by synoptophore, stereoacuity and Newcastle control score. With use of the Intermittent Exotropia Questionnaire (IXTQ), the pre- and post-operative HRQOL and pre-operative HADS were assessed within these children and their parents.Results: A total of 389 children were eligible for inclusion (47.8% male, 52.2% female, mean + SD age = 8.17 ± 2.81). Pre-operative IXTQ scores in both children and their parents were significantly correlated with near stereoacuity (P = 0.029 and P = 0.015, respectively). The angle of deviation at near vision showed a negative linear relationship with visual function (P = 0.026) and psychological (P = 0.019) scores and opinions regarding surgery(P = 0.024). HADS scores were also related with near stereoacuity (P < 0.05). After surgery, both children’s and parents’ IXTQs significantly improved (p༜0.01). Children’ IXTQ scores were related to the angle of deviation at distance and their psychological and visual function scores showed a negative relationship with the angle of deviation at near vision (P < 0.05).Conclusion: Children and parents HRQOL and HADS were associated with near stereoacuity. Parents usually attend more readily to the angle of deviation at near in their IXT children. HRQOL improved significantly after surgery and can be used as one of the indices for pre-operative evaluation, but is not recommended as a criteria for surgical intervention.These first two authors contributed equally to this work

scholarly journals Health-related quality of life and anxiety associated with childhood intermittent exotropia before and after surgical correction

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Danyi Mao ◽  
Jing Lin ◽  
Lina Chen ◽  
Jiying Luo ◽  
Jianhua Yan
Keyword(s):  
Depression Scale ◽  
Patient Reported Outcome ◽  
Strabismus Surgery ◽  
Intermittent Exotropia ◽  
Patient Reported ◽  
Before And After ◽  
Related Quality ◽  
Health Related ◽  
Angle Of Deviation

Abstract Background Intermittent exotropia (IXT) is the most common form of exotropia in children. In addition to cosmetic effects and loss of stereoscopic function, IXT may negatively impact the psychological well-being of children and their parents. The purpose of this study was to assess the patient-reported outcomes of Chinese children with IXT before and after strabismus surgery. Methods The records of children with IXT who underwent strabismus surgery at the Zhongshan Ophthalmic Center of Sun Yat-sen University, China over the period from January 1, 2016 to December 31, 2018 were prospectively recruited. All children underwent ophthalmic and orthoptic examinations, including the prism and alternate cover test, fusion function by synoptophore, stereoacuity and Newcastle control score. Two patient-reported outcome measures were used: the intermittent Exotropia Questionnaire (IXTQ) to measure disease-specific health-related quality of life (HRQOL) and the Hospital Anxiety and Depression Scale (HADS) to measure anxiety and depression. Patient-reported outcome measurements were made before and after surgery with responses from children and their parents. Results A total of 389 children were eligible for inclusion (47.8% male, 52.2% female, mean + SD age = 8.17 ± 2.81). Preoperative IXTQ scores in both children (48.21 ± 26.2) and their parents (44.6 ± 25.68) were significantly correlated with near stereoacuity (P = 0.029 and P = 0.015, respectively). The angle of deviation at near vision showed a negative linear relationship with visual function (P = 0.026) and psychological (P = 0.019) scores as well as opinions regarding surgery (P = 0.024). HADS scores (anxiety scale score: 11 ± 2.92, depression scale score: 10.44 ± 2.9) were also related to near stereoacuity (P < 0.05). After surgery, both children’s (74.83 ± 16.59) and parents’ (68.57 ± 17.06) IXTQ scores significantly improved (p<0.01). Children’s IXTQ scores were related to the angle of deviation at distance, and their psychological and visual function scores showed a negative relationship with the angle of deviation at near vision (P < 0.05). Conclusion Children and parents’ HRQOL and HADS were associated with near stereoacuity. Parents usually attend more readily to the angle of deviation at near in their IXT children. HRQOL improved significantly after surgery and can be used as one of the indices for preoperative evaluation but is not recommended as a criterion for surgical intervention.

scholarly journals Comparison of bilateral medial rectus recession vs recession-resection as surgery for infantile esotropia

2021 ◽  
Vol 12 (8) ◽  
pp. 65-70
Author(s):  
Aman Kumar Gupta ◽  
Kabindra Bajracharya ◽  
Roshan Dev Yadav ◽  
Salma K.C. Rai
Keyword(s):  
Strabismus Surgery ◽  
Surgical Correction ◽  
Medial Rectus ◽  
Infantile Esotropia ◽  
Single Vision ◽  
Significant Difference ◽  
Angle Of Deviation ◽  
Binocular Single Vision ◽  
The Mean ◽  
Group Post

Background: Infantile esotropia is misalignment of eyes from bifoveal fixation where surgical correction at an early age usually presents with good outcomes. Aims and Objective: To compare the surgical outcome between bilateral medial rectus recession (BMR) and recession- resection (RR) surgery in infantile esotropia. Materials and Methods: The study was conducted in Lumbini Eye Institute, Bhairahawa, from December 2017 to December 2018. Patients with infantile esotropia who underwent surgical correction were included in the study. Patients were examined pre operatively, and post operatively at day one and third month, where the angle of deviation was measured and the level of binocular single vision (BSV) was assessed. Data was entered and analyzed using the SPSS program. Results: Total 79 patients were included in the study out of which 33 underwent BMR and 46 underwent RR. The mean pre-operative angle by PBCT was 52.58 PD (SD ±15.468) in the BMR group and 47.83 PD (SD ±12.140) in the RR group. Post-operative deviation in the BMR group had angle <35 PD. In the RR group the post-operative deviation observed was <35 PD, whereas 1/46 patients had angle between 35-50 PD. All patients who had residual esotropia (ET) in either the BMR or RR group had a pre-operative angle above 50 PD. Pre-operatively 43% had fusion and rest of them had suppression. Post-operatively 40.5% had fusion, 15.2% had stereopsis and rest of them had suppression or BSV could not be assessed in them. Therefore, there was increase in BSV by 2.5% from fusion to stereopsis. Those who initially showed suppression or in whom the BSV could not be assessed pre-operatively now showed to have fusion or some stereopsis. In total there was 15.2% increase in stereopsis. Conclusion: Though cosmesis has been improved in most patients after strabismus surgery, BSV improvement was insignificant as most surgery was performed after attainment of visual maturity. No significant difference between BMR and RR was found in terms of improvement of angle of deviation and BSV.

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