Is the incidence of infantile esotropia declining?: a population-based study from Olmsted County, Minnesota, 1965 to 1994.

OBJECTIVE: To investigate the incidence of infantile esotropia from a defined population in the United States over a 30-year period. Recent reports from the United Kingdom have suggested that strabismus or strabismus surgery is occurring less frequently today than in previous years. METHODS: The medical records of all patients diagnosed with infantile esotropia within Olmsted County, Minnesota, from January 1, 1965, through December 31, 1994, were retrospectively reviewed. RESULTS: The birth prevalence of infantile esotropia during the 30-year period was 25 (95% confidence interval, 21-29) per 10 000, or 1 in 403 live births. Although there were slightly more cases of infantile esotropia in the earlier years (45 from 1965-1974, 51 from 1975-1984, and 34 from 1985-1994), the change in incidence over time was not statistically significant (P = .32). The mean number of surgeries performed on each patient in this cohort was similar during the 30-year study: 1.8 for those diagnosed from 1965 to 1974, 1.9 for 1975 to 1984, and 1.6 for 1985 to 1994. CONCLUSIONS: The incidence of infantile esotropia in this population has not significantly changed from 1965 through 1994. Moreover, the rate of surgical intervention over these years is similar for this patient population.

Long-term follow-up of congenital esotropia in a population-based cohort.

PURPOSE: To report the long-term outcomes of a population-based cohort of children diagnosed with congenital esotropia during a 30-year period. METHODS: The medical records of all patients diagnosed with congenital esotropia as residents of Olmsted County, MN, from January 1, 1965, through December 31, 1994, were retrospectively reviewed. RESULTS: A total of 130 children were diagnosed during the 30-year period at a median age of 7.4 months with a mean deviation of 30(Delta). During a median follow-up of 11.9 years, 126 patients underwent a mean of 1.8 strabismus surgeries. The risk for undergoing a second surgery was significantly greater in patients with a larger presenting angle (p = 0.017) and a younger age at first surgery (p = 0.006). The Kaplan-Meier rate of having a second surgery was 51% at 10 years and 66% at 20 years. For those with 6 weeks or more of follow-up from the final surgery, last examined at a mean age of 15.1 years, 42 of 94 (45%) were within 8(Delta) of orthotropia and 30 of 98 had some level of stereopsis (

Age at strabismus diagnosis in an incidence cohort of children.

PURPOSE: To compare the age at diagnosis of children with esotropia, exotropia, and hypertropia. DESIGN: Retrospective, population-based cohort study. METHODS: The medical records of all Olmsted County, Minnesota, residents < 19 years diagnosed with esotropia, exotropia, or hypertropia from January 1, 1985 through December 31, 1994 were reviewed. RESULTS: The median age at diagnosis of esotropia (n = 380), exotropia (n = 205), and hypertropia (n = 42) was 3.1 years, 7.2 years, and 6.1 years, respectively (P = .001). In the first six years of life, esotropia had the highest incidence and was more likely to occur than either exotropia or hypertropia; exotropia predominated between age seven and 12 years; and each form was similarly likely to occur between 13 and 18 years of age (P = .001). CONCLUSIONS: The age at diagnosis was significantly different for the various forms of strabismus in this population. Esotropia is the most common form in the first six years of life; beyond this age exotropia predominates until the teenage years when the three forms have a similar but decreased incidence.

Incidence and types of childhood esotropia: a population-based study.

OBJECTIVE: To describe the incidence and types of childhood esotropia in a defined population. DESIGN: Retrospective population-based cohort. PARTICIPANTS: All pediatric (<19 years of age) residents of Olmsted County, Minnesota, diagnosed with an esodeviation (> or =10 prism diopters) from January 1, 1985, through December 31, 1994. METHODS: The medical records of all potential patients identified by the resources of the Rochester Epidemiology Project were reviewed. MAIN OUTCOME MEASURES: Incidence and types of childhood esotropia. RESULTS: Three hundred eighty-five cases of childhood esotropia were identified during the 10-year period, yielding an annual age- and gender-adjusted incidence of 111.0 (95% confidence interval, 99.9-122.1) per 100,000 patients younger than 19 years of age. This rate corresponds to a cumulative prevalence of approximately 2.0% of all children younger than 6 years, with a significant decrease in older ages (P<0.0001). Of the 385 study children, the specific forms and percentages of esotropia diagnosed were as follows: fully accommodative, 140 (36.4%); acquired nonaccommodative, 64 (16.6%); esotropia associated with an abnormal central nervous system, 44 (11.4%); partially accommodative, 39 (10.1%); congenital, 31 (8.1%); sensory, 25 (6.5%); paralytic, 25 (6.5%); undetermined, 13 (3.4%); and other, 4 (1.0%). CONCLUSIONS: The incidence of childhood esotropia from this self-referred population-based study is comparable with prevalence rates reported among Western populations. Esotropia is most common during the first decade of life, with the accommodative and acquired nonaccommodative forms occurring most frequently. The congenital, sensory, and paralytic forms of childhood esotropia were less common in this population.