Clinical Manifestations and Prognosis of Convergence Insufficiency after Craniofacial Trauma

ABSTRACT

PURPOSE: To evaluate the clinical manifestation and prognosis of convergence insufficiency after craniofacial trauma. METHODS: Twelve patients injured by craniofacial trauma were analyzed for the cause of trauma, ocular and accompanied non-ocular symptoms, presence of loss of consciousness, presence of craniofacial fracture and intracranial hemorrhage, treatment modality for ocular symptoms, change in strabismic angle and near point of convergence (NPC) after treatment and prognosis using clinical records from April 2008 to December 2014. RESULTS: Traffic accidents (8 patients) were the leading cause of trauma. Near diplopia (11 patients) was the leading type of ocular symptom and other following symptoms included headache, asthenopia and reading difficulty. Ten patients experienced loss of consciousness and craniofacial fracture and intracranial hemorrhage were observed in 7 patients. Intracranial hemorrhage and craniofacial fracture occurred in 3 patients and only 1 patient had neither intracranial hemorrhage nor craniofacial fracture. All 12 patients performed orthoptic exercises, but no improvement of near strabismic angle, NPC and ocular symptoms was observed. However, 4 patients who received surgery demonstrated improvement in near strabismic angle, NPC and ocular symptoms. CONCLUSIONS: Convergence insufficiency after craniofacial trauma occurred by relatively strong traumatic force and had a poor outcome in non-surgical methods such as orthoptic exercise. Surgery was an effective treatment method rather than orthoptic exercise.