Long-standing Adult Horizontal Strabismus with Early Childhood Onset

Management of infantile and early childhood onset strabismus should be completed during early childhood to gain better binocular function and vision. The author experienced 38 adult patients who had horizontal strabismus without any adequate treatment lasting over 14 years with onset before 6 years of age. They showed large angle of deviation and deep amblyopia. After surgery, stereopsis was never developed in all of the 14 congenital strabismic patients, whereas 30% of the 24 patients with acquired onset showed gross stereopsis. There was abnormal muscular contracture requiring adjustable stutre. All of the patients showed abnormal character psychologically. This study revealed that the lunger the duration of misalignment, the greater the chance of deep amblyopia large angle of deviation, abnormal sensory and motor adaptation, psychological influence, and ahnormal muscular contracture. Therefore early initiation of therapy during early childhood should be emphasized.

Clinical Assessment of Partially Accommodative Esotropia

We studied 49 patients who showed partially accommodative esotropia retrospectively. They were glasses for accommodative component and underwent surgery for nonaccommodative one. The mean value of refractive error was +4.41 +/- 2.04 D. The mean deviation angle of accommodative component was 20.78 +/- 12.59 PD (prism diopter), and the one of non-accommodative component was 30.45 +/- 15.12 PD. Mild amblyopia was shown in 58% of these patients. The DVD or IOOA was infrequently accompanied in these patients. Stereopsis was much improved after straightening eyes. Deterioration was noticed in 14% of the patients. The longer the duration between onset and the time at straightening eyes, and the earlier the onset of deviation, the more deterioration was noticed. This study revealed that the characteristics of partially accommodative esotropia was similar to the accommodative esotropia.

Clinical Assessment of Partially Accommodative Esotropia

We studied 49 patients who showed partially accommodative esotropia retrospectively. They were glasses for accommodative component and underwent surgery for nonaccommodative one. The mean value of refractive error was +4.41 +/- 2.04 D. The mean deviation angle of accommodative component was 20.78 +/- 12.59 PD (prism diopter), and the one of non-accommodative component was 30.45 +/- 15.12 PD. Mild amblyopia was shown in 58% of these patients. The DVD or IOOA was infrequently accompanied in these patients. Stereopsis was much improved after straightening eyes. Deterioration was noticed in 14% of the patients. The longer the duration between onset and the time at straightening eyes, and the earlier the onset of deviation, the more deterioration was noticed. This study revealed that the characteristics of partially accommodative esotropia was similar to the accommodative esotropia.

The Pupils of Korean Neonates

In an attempt to know the nature of the pupils in neonates, the authors studied the pupil diameter and net miosis to the light stimulation of 70 neonates ranging from 27.3 weeks to 42.0 weeks of gestational age. The mean corneal diameter was 9.3mm. The mean pupil diameters of awakening infants (200 1ux) and in bright light stimulation were 3.1mm and 2.1mm respectively. All the cases had the response to light stimulation and the mean net miosis was 1.0mm. Anisocoria of 0.5mm to 1.0mm was detected in 11 infants (16%). Thus it may be warranted that the careful investigation to search for neurologic abnormalities is necessary if the pupil size of the neonate is more than 2 standard deviation from the mean (smaller than 1.7mm or larger than 4.5mm in dim illummation), or if their pupils do not respond to light challenge.

The Pupils of Korean Neonates

In an attempt to know the nature of the pupils in neonates, the authors studied the pupil diameter and net miosis to the light stimulation of 70 neonates ranging from 27.3 weeks to 42.0 weeks of gestational age. The mean corneal diameter was 9.3mm. The mean pupil diameters of awakening infants (200 1ux) and in bright light stimulation were 3.1mm and 2.1mm respectively. All the cases had the response to light stimulation and the mean net miosis was 1.0mm. Anisocoria of 0.5mm to 1.0mm was detected in 11 infants (16%). Thus it may be warranted that the careful investigation to search for neurologic abnormalities is necessary if the pupil size of the neonate is more than 2 standard deviation from the mean (smaller than 1.7mm or larger than 4.5mm in dim illummation), or if their pupils do not respond to light challenge.