Clinical Characteristics of Exodeviation

ABSTRACT

PURPOSE: In order to evaluate the incidence and clinical characteristics of exodeviation according to the Kushner's classification. METHODS: We prospectively studied the 820 patients with exodeviation from 1998 to 2003. One hundred thirty patients with systemic abnormalities, eye disease except exodeviation, or histories of previous strabismus operations were excluded. Best-corrected visual acuity, alternate prism cover test or Krimsky test, duction/ versions, funduscopy, and cycloplegic refraction were performed in every patient, and Bielschowsky phenomenon, Worth 4 dot test and Titmus stereotest, in possible patients. We categorized exodeviations according to the Kushner's classification. RESULTS: Of the remaining 690 patients with exodeviation, 318 were male and 372 were female. Age of onset of exodeviation was 3.9 years. Basic exodeviation was most common (76.5%), and followed by tenacious proximal fusion (7.1%), convergence insufficiency (2.8%), proximal convergence (0.6%), pseudo-convergence insufficiency (0.6%) and high AC/A ratio (0.4%). Binocular fusion both at near and at distance was observed in 30% (148 patients) of the patients. The incidence of amblyopia and dissociated vertical deviation was 13.9% and 8.5%, respectively. Bielschowsky phenomenon was observed mostly in patients with early-onset exodeviation. CONCLUSIONS: Basic exodeviation was most commonly observed, followed by tenacious proximal fusion and convergence insufficiency. Patients with exodeviation showed an onset age of 3.9 years and accompanied by an amblyopia and dissociated vertical deviation in 14% and 5%, respectively. One third of the patients showed binocular fusion.