Strabismus in paediatric age (3-16 year): a clinical study

Authors

  • Tarakeswara Rao Attada Department of Ophthalmology and Regional Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh
  • M. Deepika Department of Ophthalmology and Regional Institute of Medical Sciences, Srikakulam, Andhra Pradesh
  • S. Laxmi Department of Ophthalmology, Andhra Medical College, Visakhapatnam, Andhra Pradesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20161731

Keywords:

Strabismus, Esotropia, Exotropia, Refractive errors, Consanguinity, Divergence

Abstract

Background: Strabismus is a clinical condition in which the eyes are not aligned with each other properly. The main objective of the study was to study the prevalence, aetiology and the most common type of strabismus in children between 3- 16 years of age.

Methods: This was a prospective study conducted from November 2012 to October 2014 at Government regional eye hospital Visakhapatnam. A total of 50 patients included in this study. Children between 3-16 years of age presenting with squint included in this study. All children below 3years and above 16 years excluded from this study. Detailed history regarding the complaint, birth history, developmental history was taken. Patients were thoroughly evaluated for Visual acuity, both distance and near vision with naked eye as well as best corrected visual acuity. Thorough anterior segment evaluation using slit lamp, cycloplegic refraction using atropine (<7 years) or cyclopentolate (>7 years), fundus examination was don.

Results: A total of 9678 children attended GREH during the period of the study. Among them total number of children with strabismus was 59.Thus the prevalence of strabismus is 0.6%. Children in the age group of 3-10 years of age are more involved 37 (62.7%).   Exotropia was seen in 34 cases and esotropia in 24 cases. Commitant esotropia was more common, seen in 16 (27.1%) of cases. In exotropia commitant exotropia was more common, seen in 32 cases and incommitant in 2 cases and divergence excess seen in 9 cases.  History of consanguinity present in 22% of cases.

Conclusions: Prevalence of squint in children in 3 - 16 years age group was 0.6%. Commitant squint was more common than incommitant squint. Among commitant squint, exotropia was more common than esotropia. More research is needed to validate the role of consanguinity in strabismus.

 

References

Sihota R, Tandon R. Parsons Diseases of the eye. 20th Edition. 2011.

Fawcett SL. Disuruption and reacquisition of Binocular vision in childhood and in Adult hood. Curr. Opin ophthal. 2005;16(5):298-302.

Kothari M, Balanke S, Gawade R, Toshnival S. Comparison of psychosocial and emotional consequences of childhood strabismus on the families from rural and urban India .Indian J Ophthalmol. 2009;57:285-88.

Matsuo T, Matsuo C. The prevalence of strabismus and amblyopia in Japanese elementary school children. Ophthalmic Epidemiol. 2005;12(1):31-6.

Abrahamsson M, Fabian G, Sjostrand J. Refraction in children developing Convergent or Divergent Strabismus Brit J Ophthalmol. 1992;76:723-7.

Pediatric Ophthaalmology and Strabismus. American Academy of Ophthalmology BCSC. 2013.

Kalikivayi V, Naduvilath TJ, Bansal AK, Dandona L. Visual impairment in school children in Southern India. Indian J Ophthalmol. 1997;45:129-34.

Gupta M, Gupta BP, Chauhan A, Bhardwaj A. Ocular morbidity prevalence among school children in Shimla, Himachal, North India. Indian J Ophthalmol. 2009;57:133-8.

Adelstein AM, Scully J. Epidemiological aspects of squints. Br Med J. 1967;3(5561):334-8.

Graham PA. Epidemiology of Strabismus. Brit J Ophthalmol. 1974;58(3):224-31.

Ayanru JO. Environment, Culture and eye disease in Nigeria (experiences at Benin City, Bendel state of Nigeria). In: Proceedings of “The African Eye, Kenya, Nairobi. 1982:41-46.

Matsuo T, Matsuo C. The prevalence of strabismus and amblyopia in Japanese elementary school children. Ophthalmic Epidemiol. 2005;12(1):31-6.

Graham PA. Epidemiology of Strabismus Brit J Ophthalmol. 1974;58(3):224-31.

Adelstein AM, Scully J. Epidemiological aspects of squints. Br Med J. 1967;3(5561):334-8.

Yu CBO, Fann DSP, Wong VWY, Lam DSC. Changing patterns of strabismus: a decade of experience in Hong Kong. Br J Ophthalmol. 2002;86:854-6.

Cass EE. Divergent strabismus. Br J Ophthalmol. 1937;21(10):538-559.

Rutstein RP, Daum KM. Anomalies of binocular vision: diagnosis and management. St. Louis: CV Mosby, 1998:192-5.

Mohney BG. Common forms of childhood strabismus in an incidence report. Am J Ophthalmol. 2007;144(3):465-7.

Cotter SA, Varma R, Tarczy-Hornoch K, McKean-Cowdin R, Lin J, Wen G, et al. Borchert Met Joint writing committee for Multi ethnic Pediatric Eye disease study and the Baltimore paediatric eye disease study groups Ophthalmology. 2011;118(11):2251-61.

Remaley NA, Tamboli A, Zhao J, Podgor MJ, Klebanoff M. Risk factors for esotropia and exotropia. Arch Ophthalmol. 1994;112(10):1349-55.

Cass EE. Divergent strabismus. Br J Ophthalmol. 1937;21(10):538-559.

Rachael H, Jenkins DB. Demographic variations in the prevalence and management of exotropia. Am Orthopt J. 1992;42:82.

Chia A, Roy L, Seenyen L, Comitant Horizontal Straismus: an Asian perspective Br J Ophthalmol. 2007;91(10):1337-40.

Greenberg AE, Mohney BG, Diehl NN, Burke JP. Incidence and types of childhood esotropia: A population based study Ophthalmology. 2007;114(1):170-4.

Rantanen A, Tommila V. Prevalence of Strabismus in Finland. Acta Ophthalmol. 1990;61:506-8.

Havertape SA, Cruz OA, Chu FC. Sensory strabismus - eso or exo? J pediatr Ophthalmol Strabismus. 2001;38(6):327-30.

Tollefson MM, Mohney, BG, Diehl NN, Burke JP. Incidence and types of childhood hypertropia: A population based study. Ophthalmology. 2006;113(7):1142-5

Holmes JM, Mutyala S, Maus TL, Grill, Hodge DO, Gray DT. Pediatric third, fourth, and sixth nerve palsies: a population-based study. Am J Ophthalmol. 1999;127(4):388-92.

Mahoney NR, Liu GT. Benign recurrent sixth (abducens) nerve palsies in children. Arch Dis Child. 2009;94(5):394-6.

See LC, Song HS, Ku WC, Lee JS, Liang YS, Shieh WB. Neglect of childhood strabismus: Keelung Ann-Lo Community ocular survey 1993-1995. Changgeng Yi Xue Za Zhi. 1996;19(3):217-24.

Lee MS, Galetta Sl, Volpe NJ, Liu GT. Sixth nerve palsies in children. Pediatr Neurol. 1999;20(1):49-52.

Fells P. Management of paralytics trabismus. Br. J. Ophthalmology. 1974;58(3):255-65.

Downloads

Published

2017-01-02

How to Cite

Attada, T. R., Deepika, M., & Laxmi, S. (2017). Strabismus in paediatric age (3-16 year): a clinical study. International Journal of Research in Medical Sciences, 4(6), 1903–1909. https://doi.org/10.18203/2320-6012.ijrms20161731

Issue

Section

Original Research Articles