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Congenital Strabismus: The Common Sense Approach

Congenital Strabismus: The Common Sense Approach Abstract Results of a series of 216 patients with congenital strabismus operated on at various age levels were analyzed and bear out the following conclusions. Congenital strabismus is a common disorder. Its incidence in the overall strabismus population is at least 50% and may be higher. The first few years of life appear to be critical in the development of normal binocular single vision. Potentiation of the latent binocular reflexes is brought about by bifoveal stimulation during infancy. Early case detection and adequate surgery are mandatory if functional results are to be obtained. It is recommended that surgery be done between 6 to 12 months of age. The functional goal should be to convert a constant tropia to a phoria. This is the most useful yardstick in evaluating results. Surgery done after the second birthday almost always resulted in functional failure. References 1. Duane, A.: Fuchs' Text Book of Ophthalmology , Philadelphia and London: J. B. Lippincott Company, 1917. 2. Chavasse, F.B.: Worth's Squint , Philadelphia: P. Blakiston Sons and Company, 1939. 3. Worth, C.: Squint: Its Causes, Pathology, and Treatment , Philadelphia: P. Blakiston Sons and Company, 1929. 4. Lyle, T.K.: Worth and Chavasse Squint , London: Bailliére, Tindall, and Cox, 1950. 5. Lyle, T.K.: Treatment of Concomitant Convergent Esotropia , Trans Ophthal Soc UK , 1952. 6. Lyle, T.K., and Jackson, S.: Practical Orthoptics in the Treatment of Squint , Philadelphia: P. Blakiston Sons and Company, 1953. 7. Lyle, T.K., and Foley, J.: Prognosis in Cases of Strabismus With Special Reference to Orthoptic Treatment , Brit J Ophthal 41:129-152, 1957.Crossref 8. Lyle, T.K.: Non-Paralytic Convergent Strabismus , Amer Orthop J 14:60-64, 1963. 9. Bridgeton, G.J.O.: Convergent Squint of Early Onset: Results of Treatment , Brit Orthop J 20:45-53, 1963. 10. Taylor, D.M.: How Early is Early Surgery in the Management of Strabismus? , Arch Ophthal 70:54-58, 1963. 11. Hubel, D.H.: The Visual Cortex of the Brain , Sci Amer 209:54-62 ( (Nov) ) 1963.Crossref 12. Cogan, D.G.: Researches into Vision , Arch Ophthal 75:155-156 ( (Feb) ) 1966.Crossref 13. Wiesel, T.N., and Hubel, D.H.: Comparison of the Effects of Unilateral and Bilateral Eye Closure on Cortical Unit Responses in Kittens , J Neurophysiol 28:1029-1040, 1965. 14. Hubel, D.H. and Wiesel, T.N.: Binocular Interaction in Striate Cortex of Kittens Reared With Artificial Squint , J Neurophysiol 28:1041-1059, 1965. 15. Wiesel, T.N., and Hubel, D.H.: Extent of Recovery From the Effects of Visual Deprivation in Kittens , J Neurophysiol 28:1060-1072, 1965. 16. Costenbader, F.D.: Infantile Esotropia , Trans Amer Ophthal Soc 59:397-429, 1961. 17. Costenbader, F.D.: " Clinical Course and Management of Esotropia ," in Allen, J.H. (ed.): Strabismus Ophthalmic Symposium II , St. Louis: C. V. Mosby Company, 1958, pp 325-353. 18. Parks, M.M.: " Comitant Esodeviation in Children ," in Haik: G.M. (ed.): Strabismus: Symposium of the New Orleans Academy of Ophthalmology , St. Louis: C. V. Mosby Company, 1962, pp 31-44. 19. Parks, M.M.: Monofixational Phoria , Amer Orthop J 11:38-45, 1961. 20. Ing, M., et al: Surgery for Congenital Esotropia , Amer J Ophthal 61:1419-1427 ( (June) ) 1966. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Congenital Strabismus: The Common Sense Approach

Archives of Ophthalmology , Volume 77 (4) – Apr 1, 1967

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References (21)

Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1967.00980020480010
Publisher site
See Article on Publisher Site

Abstract

Abstract Results of a series of 216 patients with congenital strabismus operated on at various age levels were analyzed and bear out the following conclusions. Congenital strabismus is a common disorder. Its incidence in the overall strabismus population is at least 50% and may be higher. The first few years of life appear to be critical in the development of normal binocular single vision. Potentiation of the latent binocular reflexes is brought about by bifoveal stimulation during infancy. Early case detection and adequate surgery are mandatory if functional results are to be obtained. It is recommended that surgery be done between 6 to 12 months of age. The functional goal should be to convert a constant tropia to a phoria. This is the most useful yardstick in evaluating results. Surgery done after the second birthday almost always resulted in functional failure. References 1. Duane, A.: Fuchs' Text Book of Ophthalmology , Philadelphia and London: J. B. Lippincott Company, 1917. 2. Chavasse, F.B.: Worth's Squint , Philadelphia: P. Blakiston Sons and Company, 1939. 3. Worth, C.: Squint: Its Causes, Pathology, and Treatment , Philadelphia: P. Blakiston Sons and Company, 1929. 4. Lyle, T.K.: Worth and Chavasse Squint , London: Bailliére, Tindall, and Cox, 1950. 5. Lyle, T.K.: Treatment of Concomitant Convergent Esotropia , Trans Ophthal Soc UK , 1952. 6. Lyle, T.K., and Jackson, S.: Practical Orthoptics in the Treatment of Squint , Philadelphia: P. Blakiston Sons and Company, 1953. 7. Lyle, T.K., and Foley, J.: Prognosis in Cases of Strabismus With Special Reference to Orthoptic Treatment , Brit J Ophthal 41:129-152, 1957.Crossref 8. Lyle, T.K.: Non-Paralytic Convergent Strabismus , Amer Orthop J 14:60-64, 1963. 9. Bridgeton, G.J.O.: Convergent Squint of Early Onset: Results of Treatment , Brit Orthop J 20:45-53, 1963. 10. Taylor, D.M.: How Early is Early Surgery in the Management of Strabismus? , Arch Ophthal 70:54-58, 1963. 11. Hubel, D.H.: The Visual Cortex of the Brain , Sci Amer 209:54-62 ( (Nov) ) 1963.Crossref 12. Cogan, D.G.: Researches into Vision , Arch Ophthal 75:155-156 ( (Feb) ) 1966.Crossref 13. Wiesel, T.N., and Hubel, D.H.: Comparison of the Effects of Unilateral and Bilateral Eye Closure on Cortical Unit Responses in Kittens , J Neurophysiol 28:1029-1040, 1965. 14. Hubel, D.H. and Wiesel, T.N.: Binocular Interaction in Striate Cortex of Kittens Reared With Artificial Squint , J Neurophysiol 28:1041-1059, 1965. 15. Wiesel, T.N., and Hubel, D.H.: Extent of Recovery From the Effects of Visual Deprivation in Kittens , J Neurophysiol 28:1060-1072, 1965. 16. Costenbader, F.D.: Infantile Esotropia , Trans Amer Ophthal Soc 59:397-429, 1961. 17. Costenbader, F.D.: " Clinical Course and Management of Esotropia ," in Allen, J.H. (ed.): Strabismus Ophthalmic Symposium II , St. Louis: C. V. Mosby Company, 1958, pp 325-353. 18. Parks, M.M.: " Comitant Esodeviation in Children ," in Haik: G.M. (ed.): Strabismus: Symposium of the New Orleans Academy of Ophthalmology , St. Louis: C. V. Mosby Company, 1962, pp 31-44. 19. Parks, M.M.: Monofixational Phoria , Amer Orthop J 11:38-45, 1961. 20. Ing, M., et al: Surgery for Congenital Esotropia , Amer J Ophthal 61:1419-1427 ( (June) ) 1966.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Apr 1, 1967

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