Book chapter
Comitant Strabismus
Albert and Jakobiec's Principles and Practice of Ophthalmology, pp.6925-6945
Springer International Publishing, Fourth edition
04/23/2022
DOI: 10.1007/978-3-030-42634-7_289
Abstract
When strabismus is comitant, the angle of deviation is similar regardless of the direction of gaze or the fixating eye. Comitant horizontal deviations are generally not associated with underlying serious CNS pathology; thus, the distinction between comitant and incomitant strabismus is clinically important.
In the first few months of life, normal infants may demonstrate variable degrees of esotropia and/or exotropia. The ideal outcome of early surgery for infantile esotropia is attainment of high-grade stereoacuity. More often the large-angle esotropia is converted to a microesotropia (monofixation syndrome) with the development of peripheral fusion and a central suppression scotoma. It is estimated that infantile exotropia is 150–300 times less common than infantile esotropia. In contrast, transient exodeviations are relatively common in healthy neonates.
In older children, uncorrected hypermetropia and decompensated monofixation syndrome are the most common etiological factors in acquired comitant esotropia. The clinician must recognize that over time comitant forms of strabismus may develop associated features that may not be comitant and thought to reflect poor binocular vision development. These include latent nystagmus, optokinetic nystagmus asymmetry, dissociated vertical deviation, and inferior oblique overaction.
Children with intermittent exotropia and esotropia may have a tendency to squint one eye in bright illumination; hence, the term “squint” has become synonymous with strabismus in some countries. Children with refractive/accommodative esotropia (typically >2.5 diopters of hyperopia) present around age 2–3 years, at a time when toddlers are learning to explore the “near world” at hand.
Details
- Title: Subtitle
- Comitant Strabismus
- Creators
- David SamiScott A LarsonMichael Chiang
- Resource Type
- Book chapter
- Publication Details
- Albert and Jakobiec's Principles and Practice of Ophthalmology, pp.6925-6945
- Edition
- Fourth edition
- Publisher
- Springer International Publishing; Cham
- DOI
- 10.1007/978-3-030-42634-7_289
- Language
- English
- Date published
- 04/23/2022
- Academic Unit
- Ophthalmology and Visual Sciences
- Record Identifier
- 9984244594902771
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