ABSTRACT
OBJETIVO: Identificar os tipos de desvios oculares e suas freqüências nos pacientes encaminhados ao ambulatório de motilidade ocular extrínseca do Hospital do Servidor Público Estadual de São Paulo. MÉTODOS: Foram revisados 935 prontuários do ambulatório de motilidade ocular extrínseca do ano de 2005. Os pacientes foram avaliados quanto à idade, sexo e tipo de desvio apresentado na posição primária do olhar, sendo submetidos esses dados à avaliação estatística. RESULTADOS: A esotropia foi o desvio com maior prevalência na população estudada (44,52 por cento). Neste grupo houve predomínio de indivíduos do sexo masculino (p=0,001). Este desvio foi mais freqüente na faixa etária de 0-2 anos (p=0,009). Já a exotropia (12,25 por cento) mostrou-se mais freqüente entre as mulheres (p=0,046), sendo predominante na faixa etária superior aos 47 anos de idade (p=0,001) CONCLUSÃO: Observou-se maior número de esodesvios em relação aos exodesvios. As esotropias foram mais freqüentes no sexo masculino em faixas etárias mais jovens. Já as exotropias se apresentaram em maior número no sexo feminino em faixas etárias mais elevadas. O maior número de exoforias foi encontrado em pacientes com idades entre 16 e 20 anos.
PURPOSE: To evaluate the frequency of different types of ocular deviations in patients referred to the strabismus sector at the Hospital do Servidor Público Estadual de São Paulo - Brazil. METHODS: A retrospective study of 935 records of patients examined at the strabismus sector in 2005 was conducted to evaluate sex, age and types of misalignments in the primary position. Statistical analysis was applied to these data. RESULTS: Esotropia was the most prevalent misalignment in this population (44.52 percent). There were more males in this group (p=0.001) with a predominance of the age group 0-2 years (p=0.009). Exotropia (12.25 percent) was more frequent in females (p=0.046) in the age group 46 years and over (p=0.001). CONCLUSION: Esodeviations were more frequent than exodeviations. Esotropia was more prevalent in males early in life, while exotropia was more frequent in older females. The larger number of exophorias was found in the age group 16-20 years.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Esotropia/epidemiology , Exotropia/epidemiology , Age Distribution , Brazil/epidemiology , Chi-Square Distribution , Prevalence , Retrospective Studies , Sex DistributionABSTRACT
PURPOSE: To describe the clinical characteristics of spontaneous, late-onset comitant acute, nonaccommodative esotropia (ANAET) in children. MATERIALS AND METHODS: Clinical characteristics of a cohort of patients under 16 years of age with ANAET were studied retrospectively. RESULTS: Of 15 patients eight were females. Mean age was 7.15 years (range 2.5-13, SD 3.34). Mean age of the onset of deviation was 3.2 years (range 1.5-9, SD 2.26). Mean duration of strabismus was 36 months (range 3-132, SD 43). History of a precipitating event was present in five patients (33.3%). Mean cycloplegic refraction was 1.84 diopter sphere (range -5.75 to +7.25, SD 3.55). Mean esodeviation for near and distance fixation was 40 prism diopter (range 15-90, SD 23.9). None had near/distance disparity of more than 5 prism diopter. Amblyopia was present in 13 cases (87%). Strabismus surgery was performed for eight patients. Five patients had orthophoria and three were aligned within 8 prisms esodeviation. CONCLUSION: ANAET is more common than previously reported, has a variable time of onset and high incidence of amblyopia. Timely management would avert emergence of amblyopia and vertical incomitance thereby promising better binocular outcome.
Subject(s)
Accommodation, Ocular/physiology , Acute Disease , Adolescent , Age of Onset , Child , Child, Preschool , Esotropia/epidemiology , Eye Movements/physiology , Female , Follow-Up Studies , Humans , Incidence , India/epidemiology , Male , Oculomotor Muscles/physiopathology , Ophthalmologic Surgical Procedures , Prognosis , Refraction, Ocular , Retrospective StudiesABSTRACT
PURPOSE: To investigate the clinical course in patients who underwent surgical correction of consecutive esotropia. METHODS: The medical records of 13 patients who underwent surgical correction of consecutive esotropia were reviewed retrospectively. The authors investigated the deviation and surgical method at the time of exotropia surgery. During the follow up period, the authors also studied incidence of amblyopia development, the effect of occlusion therapy, surgical methods for consecutive esotropia, and postoperative change of deviation. RESULTS: The average exodeviation was 27.1 prism diopter (PD). Bilateral lateral rectus muscle recession was performed in all patients. In all patients, alternate occlusion was tried from 2 weeks after development of consecutive esotropia. However, there was no effect on 7 patients. None of the patients developed amblyopia. Surgery for consecutive esotropia was performed on the average 15.3 months after exotropia surgery. The average esodeviation was 21.1PD. Medial rectus muscle recession was performed in 10 patients and lateral rectus muscle advancement in 3 patients. The average deviation of the subject group immediately after surgery was 1.2PD esodeviation, 0.9PD esodeviation one month after surgery, 2.4PD exodeviation 6 months after surgery, and 4.7PD exodeviation at the last follow up, and it showed a tendency to progress to exodeviation as the follow up period increased. Ten patients (76.9%) showed deviation within 8PD at the last follow up. CONCLUSIONS: The success rate of surgical correction for consecutive esotropia was a favorable outcome. But, careful decisions of the surgical method and amount is needed because the conversion of exodeviation during long-term follow-up is possible.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Esotropia/epidemiology , Exotropia/physiopathology , Eye Movements/physiology , Follow-Up Studies , Incidence , Oculomotor Muscles/physiopathology , Ophthalmologic Surgical Procedures/methods , Postoperative Complications , Retrospective Studies , Time Factors , Treatment OutcomeABSTRACT
PURPOSE: To report the incidence and the factors of consecutive esotropia (ET) in patients with immediate postoperative overcorrection of at least 17 prism diopters (PD) after surgery for intermittent exotropia (X(T)). METHODS: Four-hundred-five patients under the age of 18 were included in this study. They underwent bilateral lateral rectus recession (LROU-rec) or unilateral recession-resection (R&R) for X(T). On postoperative day one, the patients with at least 17 PD overcorrection were classified as group 1 and those with less than 17 PD as group 2. Age, refractive error, type of surgery, lateral incomitancy, and the incidence of consecutive ET were analyzed for each group. RESULTS: Group 1 consisted of 116 patients (28.6%) and group 2 consisted of 289 (71.4%). At the six-month follow-up visit, consecutive ET had developed in 16 patients (13.8%) in group 1, and in five patients (1.7%) in group 2 (p<0.001). The occurrence of consecutive ET was not related to age at the time of surgery (p=0.46 in group 1 ; p=0.54 in group 2), refractive error (p=0.18 in group 1 ; p=0.08 in group 2), or the type of surgery (p=0.69 in group 1 ; p=1.00 in group 2). The incidence in group 1 was 23.8% in patients with lateral incomitancy and 8.1% in patients without lateral incomitancy (p<0.05). In group 2, the incidence was 4.4% in patients with lateral incomitancy and 0.5% in patients without lateral incomitancy (p=0.04). CONCLUSIONS: Consecutive ET developed in 13.8% of patients with immediate overcorrection of at least 17 PD. Lateral incomitancy was the most important risk factor.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Esotropia/epidemiology , Exotropia/physiopathology , Follow-Up Studies , Incidence , Oculomotor Muscles/surgery , Ophthalmologic Surgical Procedures/adverse effects , Severity of Illness IndexABSTRACT
OBJETIVO: Relatar os achados oftalmológicos em portadores de múltiplas deficiências. MÉTODOS: Foram estudados 274 usuários do Sistema Unico de Saúde atendidos no Departamento de Oftalmologia Pediátrica e Estrabismo da Fundação Altino Ventura (FAV), no período de junho a setembro de 2004. RESULTADOS: A freqüência dos pacientes quanto ao gênero foi de 58,5 por cento para o masculino e 41,5 por cento para o feminino. A variação das idades foi de 0,1 a 20 anos com mediana de 5. A maioria (61,3 por cento) dos pacientes apresentava boa acuidade visual, contudo 38,7 por cento apresentava baixa de visão (< 20/80). As heterotropias foram vistas em 66 pacientes (24,0 por cento). Os transtornos refracionais mais freqüentes foram astigmatismo (53,2 por cento) e hipermetropia (29,0 por cento). CONCLUSÃO: Crianças com múltiplas deficiências necessitam de diagnóstico e tratamento oftalmológico precoce, possibilitando um melhor desenvolvimento global. A integração de uma equipe multidisciplinar constituída de pediatras, oftalmologistas pediátricos e profissionais de visão subnormal pode assegurar melhor qualidade na reabilitação visual.
PURPOSE: To report the visual findings in patients with multiple handicaps. METHODS: Two hundred and seventy-four patients cared for at the Pediatric and Strabismus Ophthalmology Department of the "Fundação Altino Ventura" - Brazilian National Health System, were examined from June to September 2004. Age varied from 0.1 to 20 years with a median of 5. RESULTS: The majority of the patients (61.3 percent) presented good visual acuity; however low visual acuity (< 20/80) was observed in 38.7 percent of the patients. Heterotropias were observed in 66 patients (24.0 percent); astigmatism (53.2 percent) and hyperopia (29.0 percent) were more frequent. CONCLUSION: Children with multiple handicaps need an early ophthalmologic diagnosis and treatment for better global development. The integration of a multidisciplinary team with pediatricians, pediatric ophthalmologists and specialists in low vision, may assure a better visual rehabilitation.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Disabled Persons/statistics & numerical data , Refractive Errors/diagnosis , Vision Disorders/diagnosis , Visual Acuity/physiology , Brazil/epidemiology , Diagnostic Techniques, Ophthalmological , Early Diagnosis , Esotropia/diagnosis , Esotropia/epidemiology , Exotropia/diagnosis , Exotropia/epidemiology , Vision Disorders/epidemiology , Vision, Low/diagnosis , Vision, Low/epidemiologyABSTRACT
Fue nuestra intención, al iniciar este trabajo, presentar una visión panorámica de la situación epidemiológica, química y terapéutica de la esotropia congénita en el Instituto Nacional de Salud del Niño de Lima-Perú, en un lapso de tiempo que alcanzó los últimos 10 años. Asimismo, el propósito de incluír un número considerable de pacientes se sustenta en la posibilidad de realizar pruebas estadísticas que fueran significativas, permitiendo conclusiones y proyectos futuros válidos. Considerando los 3 requisitos de un inicio entre los 0 y 6 meses, una medida de la desviación angular y el diagnóstico de esotropia congénita, se obtuvo un total de 864 pacientes, cuyos datos epidemiológicos, clínicos y de tratamiento fueron procesados por medio de computadora, procediéndose a continuación a aplicar en ellos las pruebas estadísticas pertinentes. Los principales resultados de allí derivados, fueron los siguientes: La isotropia congénita se distribuye por igual en ambos sexos, presenta cierta proporción de antecedentes familiares positivos, pero la literatura no describe aún el o los mecanismos de herencia. Los promedio de edad de primera consulta y de primera cirugía son tardías, y en especial la última bastante elevada con respecto a las recomendaciones de múltiples reportes; esto se aunó a bajos promedios de seguimiento, particularmente en los grupos de los no operados y tasas moderadas de abandono. las pruebas estadísticas no demostraron la existencia de diferencias entre estos valores de edades y seguimientos a largo del tiempo de estudio. Se discutió respecto a las raices socioeconómicas del problema que han determinado la trayectoria invariable antes descritas y el aspecto cultural sobre el cual incidí si ha de intentarse algún posible cambio. La medida de la desviación angular señaló un promedio significativamente mayor para el síndrome de Ciancia, siendo la prueba de Hirschberg la más usada; un análisis exhaustivo de los resultados no mostró diferencia entre los resultados generales y post-quirúrgicos, para el total de pacientes, subgrupos de errores de refacción de pacientes comprendidos en cada error de refracción y diversas características del estrabismo en estudio; esto permitió concluír que: excepto los pacientes con astigmatismo y hipermetrópico que se asociarian a una mayor proporción de edotropia monocular, ningún tipo de error de refraccirn se asocia a la esotropia congénita, reafirmando su carácter de tal, frente a la de tipo acomodativo. En la mayo
Subject(s)
Humans , Infant, Newborn , Infant , Female , Esotropia/epidemiology , Esotropia/congenital , Esotropia/diagnosis , Esotropia/therapy , Peru , Socioeconomic FactorsABSTRACT
Convergent squint is the most common typ.e of squint seen among our patients. It is either concomitant [ninty eight per cent] 98 Yr or paralytic [two per cent] 2%due to paralysis or paresis of external rectus muscle. Concomitant squint my be alternating [twenty per cent] either essential alternators [twenty five per cent] or accomodative alternating convergent squint [seventy five per cent]