Clinical Analysis of Sensory Strabismus with Organic Amblyopia in Children

ABSTRACT

PURPOSE: To study the clinical characteristics of pediatric sensory strabismus in Korean children. METHODS: A retrospective analysis was performed on 71 patients with the diagnosis of sensory strabismus before the age of 16 years. Patients with strabismic amblyopia or anisometropic amblyopia were excluded from consideration. The age at onset of vision loss, diagnosis, type of strabismus, deviated angle, etiologic factors leading to vision loss, and visual acuity of the deviated eye were recorded. The surgical results were analyzed in the case of strabismus surgery for sensory strabismus. RESULTS: The mean age at the onset of vision loss was 4.6 years and the mean age at diagnosis was 7.5 years. Forty-one patients (58%) had congenital vision loss and the most common cause of vision loss was optic nerve disease in 35 (49%). Exotropia developed in 58 (82%), and patients with severely impaired visual acuity were more likely to develop exotropia (P=0.054). The age at the onset of vision loss and the age at diagnosis in esotropia were younger than in exotropia (P=0.049, P=0.047, respectively). Twenty-five (78%) of 32 patients who had undergonewere strabismus surgery had ocular alignment within 10 prism diopters of orthophoria. The frequency of consecutive exotropia was 40% in surgery for esotropia. CONCLUSIONS: Children with organic amblyopia tend to develop sensory exotropia. We considered that the age at initial vision loss and the severity of vision loss could play a role in determining the direction of deviation. The surgical results were favorable, but we should pay attention to the development of consecutive exotropia in surgery for esotropia.