Title: Treatment Outcomes in Concomitant Esotropias

Authors: Dalia S, Anitha.S

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.69

Abstract

Purpose: To assess the outcome of various treatment modalities of concomitant esotropias.

Design: Prospective randomized population based study.

Materials & Methodology: 100 patients who attended squint clinic of Regional institute of Ophthalmology, Thiruvananthapuram were included in the study.

Results: Of the 100 cases in our study,31% had amblyopia at presentation of which majority (61.29%) improved with occlusion therapy (improvement of 2 lines or more ).Of the patients treated by non surgical methods (19 patients), 84.21% & 73.68% attained acceptable anatomical outcome and some form of BSV respectively by treatment. Of the surgically treated group not much difference in motor alignment was noted by symmetrical bimedial recession (70.21%) or asymmetrical recession-resection (67.86%) surgery for esotropia. The refractive status after surgery showed a Myopic change in both spherical and astigmatic component, but only meridional equivalent at 180° was statistically significant (-0.21± 0.28).

Conclusion: From the study it is evident that conventional occlusion therapy is a simple and cost effective treatment for amblyopia. Ideal treatment by non-surgical or surgical methods or combination of both if advocated early will help to attain acceptable anatomical and sensory outcome thus eliminating or else decreasing the density of amblyopia.

Keywords: Concomitant Esotropia, Amblyopia, Bimedial Recession, Recession-Resection.

References

  1. K and Pajakowa J - The sensorial state of strabismus in orthoptics,1972; Excerpta  Medica Foundation, p.72.
  2. F.D: Clinical course and management of Esotropia, Strabismus Ophthalmology symposium 2, St.Louis, 1958.
  3. F.D: Infantile Esotropia, Trans Am.Ophthalmol. Society,1961
  4. Efficacy of conventional occlution therapy in Amblyopia- Dr.Kalpana Narendran and  Ramakrishnan, Aravind Eye Hospital, Coimbatore, India 1999
  5. Noorden, G.K,Morris.J and Edelman. P: Efficacy of bifocals in the treatment of accommodative esotropia, Am.J. Ophthal, 1978
  6. Parks, M.M: Abnormal accommodative convergence in squint.Arch.Ophthal,1958
  7. Z.F: Accomodative Esotropia, Arch.Ophthal,1976
  8. J.A: Non surgical treatment of Esotropia. Trans. New Orleans Academy of Ophthalmology, St.Louis,1971
  9. Von Noorden, G.K, et al: Surgical treatment of congenital esotropia. Trans. Am. Acad Ophthal,1972
  10. J.B. et al: Comparitive study of surgical management of congenital esotropia. Peadiatric Ophthal and Strabismus,1976.
  11. Surgical results of congenital esotropia: BMR vs Uniocular R/R, Dr. Vijayalekshmi et al Madurai,India 1999.
  12. Barley et al: Characteristics of R/R and BMRfor childhood esotropia. Arch Ophthal,1985
  13. A, Barker JD. Refractive changes following strabismus surgery. Am Orthoptic Journal,1985
  14. M, Nissenkorn.I, Buckman.G et al. Post operative refractive changes in congenital esotropia.1989
  15. Dr. Kamalesh, Dr. Shailley Jain, Guru Nanak Eye Centre, New Delhi. Change in refractive status   following strabismus surgery.

Corresponding Author

Dalia S

Shanti Bhavan, Near South Panchayath Office, Punnapra,

Alappuzha, Kerala, India, Pin: 688004

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., +919447142877