Clinical Analysis of Strabismus in Twin

PURPOSE: To evaluate the genetic factor in development of comitant strabismus. METHODS: We retrospectively reviewed 48 patients of 24 twins classified into monozygotic or dizygotic twin and analyzed gestational period and birth weight, refraction, phenotype and age of onset, amount of deviation, surgical history, and associated systemic or other ocular anomaly except strabismus. RESULTS: Seventeen of the 24 twins (70.8%) showed phenotypic concordance. The concordance was significantly higher in monozygotic twins (15 of the 18 pairs, 83.3%) than in dizygotic twins (2 of the 6 pairs, 33.3%) (p=0.038). Out of 15 twins with monozygosity who showed concordance, the predominant phenotype was intermittent exotropia (9 pairs, 60.0%). Concordance rate according to phenotype was high in refractive or nonrefractive accommodative esotropia (3 of the 3 pairs, 100.0%) and intermittent exotropia (9 of the 10 pairs, 90.0%). Most of concordant pairs showed similarity in age of onset and amount of deviation between first and second child. CONCLUSIONS: The concordance rate in monozygotic twin was high, especially in refractive or nonrefractive accommodative esotropia and intermittent exotropia, and therefore genetic factor can be responsible for the development of these types of strabismus.

Mechanical Treatment of Phthiriasis Palpebrarum

Phthiriasis palpebrarum is a rare disease in which crab lice infest the eyelashes. It can cause pruritic lid margins or unusual blepharoconjunctivitis and is difficult to diagnose and treat. We diagnosed and managed a case of phthiriasis palpebrarum in both upper eyelids, accompanied by nits, on the scalp of a 6 year-old female child. We removed the eyelashes, including lice and nits, by pulling with fine forceps without sedation. On the second month after treatment, all lice and nits were eradicated without recurrence and the eyelashes grew back. In conclusion, phthiriasis palpebrarum can be diagnosed by close examination of the eyelashes and eyelid margins with slit lamp and can be managed mechanically.