Strabismus (Strabismus )

Publisher: Taylor & Francis


Strabismus is a quarterly, serving strabismologists worldwide. The journal publishes articles on strabismus and related fields such as neuro-physiology.

  • Impact factor
  • 5-year impact
  • Cited half-life
  • Immediacy index
  • Eigenfactor
  • Article influence
  • Website
    Strabismus website
  • Other titles
    Strabismus (Online)
  • ISSN
  • OCLC
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Taylor & Francis

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 month embargo for STM, Behavioural Science and Public Health Journals
    • 18 month embargo for SSH journals
  • Conditions
    • Some individual journals may have policies prohibiting pre-print archiving
    • Pre-print on authors own website, Institutional or Subject Repository
    • Post-print on authors own website, Institutional or Subject Repository
    • Publisher's version/PDF cannot be used
    • On a non-profit server
    • Published source must be acknowledged
    • Must link to publisher version
    • Set statements to accompany deposits (see policy)
    • Publisher will deposit to PMC on behalf of NIH authors.
    • STM: Science, Technology and Medicine
    • SSH: Social Science and Humanities
    • 'Taylor & Francis (Psychology Press)' is an imprint of 'Taylor & Francis'
  • Classification
    ​ yellow

Publications in this journal

  • [show abstract] [hide abstract]
    ABSTRACT: To evaluate the correlation between the degree of anisometropia with depth of amblyopia and presence of stereopsis. A retrospective chart review of 119 patients treated during 1995-2004 was carried out. All patients had undergone a full ophthalmological examination. Inclusion criteria were: anisometropia >1 diopter (spherical and/or cylindrical), age at first examination between 2 and 8 years, no previous optical correction, absence of ocular and neurological disorders, absence of ocular motility disorders, and minimum follow-up of 2 years (mean 7.9 +/- 4.3). Optical correction was prescribed at first visit and, at a second visit, the need for patching or penalization was evaluated. The results show a correlation between the degree of anisometropia and visual acuity at first visit (p < 0.001). There were, however, several subjects with good levels of visual acuity despite considerable anisometropia, and also subjects where mild or moderate anisometropia was sufficient to induce a severe amblyopia. Compared to other types of anisometropia, anisomyopic patients appeared to have a higher degree of binocular vision recovery when corrected optically. First evaluation with the presence of good stereoacuity seems to be a prognostic indicator for amblyopic recovery. This study demonstrates the difficulty of developing a guideline for screening and treatment of anisometropia. Even though there seems to be a correlation between type and degree of anisometropia in a majority of patients, there is also a significant number of cases that do not follow this pattern. Another important observation is the presence of binocular vision at the first evaluation as a good prognostic indicator for visual recovery with optical correction alone, even without penalization therapy.
    Strabismus 07/2009; 15(4):209-14.
  • [show abstract] [hide abstract]
    ABSTRACT: To investigate heterotropia, heterophoria, head posture, nystagmus, stereo acuity, ocular motility and near point of convergence (NPC) in children with hydrocephalus treated surgically before 1 year of age. In addition, the effects of being born with hydrocephalus, the effect of the etiology of hydrocephalus, number of shunt revisions and the size of the ventricles on these variables were studied. A population-based study was performed in 75 children and the results were compared with the results of an age- and sex-matched group (comp group) (n = 140). Heterotropia 68.9% (comp group 3.6%; p < 0.001), abnormal head posture 41.3% (comp group 0; p < 0.001), nystagmus 44.0% (comp group 0; p < 0.001), stereo acuity < or =60'' 33.8% (comp group 97.1%; p < 0.001) and ocular motility defects 69.7% (comp group 0.7%; p < 0.001) were more common among children with hydrocephalus than in the comparison group. Children with overt hydrocephalus at birth had significantly more heterotropia (p = 0.0006), esotropia (p = 0.002), abnormal head posture (p = 0.02) and motility defects (p = 0.003) compared to those with hydrocephalus developing during the first year of life. The etiology, number of shunt revisions and the size of the ventricles had no significant effect on any of the investigated variables. Children with hydrocephalus surgically treated before the age of one year commonly present orthoptic abnormalities. The etiology of hydrocephalus, number of shunt revisions and ventricle size seem to be of minor importance compared with the age of onset of hydrocephalus with regard to the risk for orthoptic abnormalities.
    Strabismus 07/2009; 15(2):79-88.
  • Strabismus 01/2008; 16(1):1-2.
  • [show abstract] [hide abstract]
    ABSTRACT: In the presence of both strabismus and cataract, it is always a dilemma whether to manage them separately or together. In this paper, the authors evaluate the results of combined strabismus and cataract surgery. The records of 50 patients were reviewed retrospectively. They were divided into two groups: those who developed strabismus first and cataract later (group 1, n = 17 patients) and those who developed cataract first and strabismus later (group 2, n = 33 patients). Motor alignment (less than 10 prism diopters) was achieved in 35.3% in group 1 and 75.8% in group 2. Visual success (20/40 or better) was attained in 70.6% in group 1 and 57.6% in group 2. In group 1, when the angle of deviation was more than 80 prism diopters, poor motor alignment was achieved (25%). Surgical success after one operation was achieved in the majority of all eyes that had combined surgery. In selected cases, combined strabismus and cataract surgery is a safe and effective procedure, optimizing the alignment of the visual axes, improving visual acuity, and minimizing the need for additional procedures.
    Strabismus 01/2008; 16(1):5-9.
  • [show abstract] [hide abstract]
    ABSTRACT: To report the phenomenon of newly-noted binocular diplopia following vision improvement in patients with sensory strabismus secondary to keratoconus, and to document the effect of strabismus surgery on this diplopia. Retrospective institutional case series [1982--2005] of records coded with keratoconus and strabismus. Keratoconus patients with visual acuity that could not be improved, childhood strabismus, known reason for acquired strabismus (other than decreased vision from kerataconus), decreased vision from other ocular disease, monocular diplopia, failure of strabismus surgery, and/or less than six months follow-up after strabismus surgery were excluded. Although 103 medical records were identified, only seven met the strict inclusion criteria. All seven patients presented with gradual reduction in vision (not due to their strabismus), and none initially complained of diplopia. After intervention to improve visual acuity, six complained of constant binocular diplopia. This diplopia resolved after successful strabismus surgery. Postoperative Worth four-dot testing demonstrated suppression. Binocular diplopia, noted after intervention to improve visual acuity in our patients with strabismus secondary to long-standing uncorrected keratoconus, resolved after successful surgical alignment. Our patients may have developed suppression from uncorrected keratoconus before their sensory strabismus occurred.
    Strabismus 01/2008; 16(1):19-22.
  • Strabismus 01/2008; 16(1):39-44.
  • [show abstract] [hide abstract]
    ABSTRACT: The ocular motility (OM) deficit in myasthenia has not been studied systematically. Anecdotal reports yield no consensus, with the pattern mimicking infranuclear, internuclear or supranuclear disorders. The current study defines the pattern of extra-ocular muscle (EOM) weakness at presentation for a group of newly diagnosed untreated ocular myasthenics (OMG). Cases referred to one consultant neurologist (RAM) between 1991 and 2001 were reviewed. EOM weaknesses were quantified using an established scoring method in 49 patients with OMG and 49 age- and sex-matched controls, to differentiate age-related changes from those secondary to myasthenia. Bilateral and multiple EOM weaknesses were typical. Only 6 cases mimicked isolated cranial nerve palsy. Weakness of the elevator muscles (superior rectus and inferior oblique) was common in both the OMG and control groups, but the amount of weakness was significantly greater for the myasthenia group (p = 0.003). All control subjects had a normal range of depression. EOM weaknesses for the control group were not confined to the older subjects. This is the first detailed analysis of EOM involvement in ocular myasthenia. The EOM weaknesses for the control group were invariably bilateral and symmetrical, mainly involving the superior recti. The preponderance for involvement of the elevator muscles is discussed.
    Strabismus 01/2008; 16(1):11-8.
  • [show abstract] [hide abstract]
    ABSTRACT: INTRODUCTION: Malformations of the cerebellum have been well-known to coexist with abnormalities of the oculomotor system. Rhombencephalosynapsis (RES) is a rare malformation of the cerebellum of unknown etiology in which the vermis is hypoplastic and the two cerebellar hemispheres are fused. The type of oculomotor disorders associated with RES is not well documented in the literature. Here, two cases are presented. CASE 1: A 15-year-old girl presented with large-angle infantile esotropia and inferior oblique overaction. Slow (3 to 4 cps) rhythmic anteroposterior oscillation movement of the head was observed while walking and left-sided postural tremor was present. CASE 2: An 8-month-old baby girl presented with facial dysmorphism, right esotropia, anisometropia, motor delay and truncal ataxia. Cranial MRI demonstrated RES in both patients. CONCLUSION: The clinical findings in two children presenting with infantile esotropia and RES may suggest a role of the vermis in ocular alignment. Head nodding in a child with strabismus can be observed only when walking and its presence should prompt neuroimaging.
    Strabismus 01/2008; 16(1):23-7.
  • [show abstract] [hide abstract]
    ABSTRACT: A 30-year-old male suffered an orbital trauma due to a traffic accident. At the Emergency Unit, the patient presented with avulsion of the upper left eyelid in the medial canthus, wounds in the lower eyelid and the inferior canaliculus, conjunctival laceration, proptosis and palpebral hematomas. The patient reported persistent diplopia. During the examination, exotropia and total absence of adduction were observed. Computerized tomography (CT) revealed a discontinuity at the left medial rectus. No orbital fractures were identifiable. The medial rectus was still attached to its anatomic insertion at the globe. The discontinuity was suggestive of laceration or rupture of this muscle at approximately 10-12 mm from its insertion. Surgical exploration revealed total rupture of the medial rectus at approximately 12 mm from its insertion. The posterior edge of the damaged muscle was found and sutured to its anterior edge with 6-0 polyglactin. The following day, the eyes were completely straight and the patient did not mention any signs of diplopia. Botulinum toxin injection into the ipsilateral lateral rectus was not necessary. After six months of follow-up, the patient still reported no diplopia. When muscular laceration is suspected after an orbital trauma, early CT is recommended. The only procedures that assure a significant recovery of the normal function of the eye are early muscle repair and avoidance, if possible, of transposition surgery.
    Strabismus 01/2008; 16(1):33-7.
  • [show abstract] [hide abstract]
    ABSTRACT: Smoking cannabis has been described to reduce acquired pendular nystagmus in MS, but its effect on congenital nystagmus is not known. To report the effect of smoking cannabis in a case of congenital nystagmus. A 19-year-old male with congenital horizontal nystagmus presented to the clinic after smoking 10 mg of cannabis. He claimed that the main reason for smoking cannabis was to improve his vision. At the next clinic appointment, he had not smoked cannabis for 3weeks. Full ophthalmologic examination and eye movement recordings were performed at each visit. Visual acuity improved by 3 logMar lines in the left eye and by 2 logMar lines in the right eye after smoking cannabis. The nystagmus intensities were reduced by 30% in primary position and 44%, 11%, 10% and 40% at 20-degree eccentricity to the right, left, elevation and depression, respectively, after smoking cannabis. Cannabis may be beneficial in the treatment of congenital idiopathic nystagmus (CIN). Further research to clarify the safety and efficacy of cannabis in patients with CIN, administered for example by capsules or spray, would be important.
    Strabismus 01/2008; 16(1):29-32.
  • Strabismus 01/2008; 16(1):3.
  • [show abstract] [hide abstract]
    ABSTRACT: Performance in the visual environment was evaluated with a central fixation or a search target in 11 positions within 34 degrees on a CRT, superimposed on a landscape. Reaction times were recorded. We examined 24 patients aged 26-83, with lesions of the visual pathways and homonymous visual field defects, and 18 normal subjects aged 23-79. This simple test takes about 1 minute in normal subjects and four or more minutes in neurological patients. The test may be used to quantify saccadic adaptation to disability from homonymous field defects and to monitor the training effects of visual rehabilitation.
    Strabismus 01/2007; 15(1):7-11.
  • [show abstract] [hide abstract]
    ABSTRACT: To determine angle kappa values in strabismic individuals by means of a synoptophore. One hundred-and-eight strabismic subjects and 102 healthy subjects who served as a control group were enrolled in the study. A complete ophthalmologic examination, including determination of refractive status, best-corrected visual acuity measurement, slit-lamp biomicroscopic anterior segment evaluation, intraocular pressure measurements with a Goldmann applanation tonometer, and dilated fundus examination, was done on all study participants. Orthoptic examination included Krimsky prism reflex test, prism cover test, and duction tests. Strabismic patients were grouped into two categories according to their deviation types: exotropic and esotropic. A synoptophore (Clement Clarke, London, England) with a specially designed slide (Maddox test slide series A White Binding No: 16; Clement Clarke, London, England) was used to measure angle kappa. Of the 108 strabismic patients, 62 were males and 46 were females with a mean age of 23.38 +/- 3.68 years (range: 8 to 82 years). There were 54 males and 48 females with a mean age of 32.74 +/- 1.63 years (range: 7 to 68 years) in the control group. The exotropic group had significantly higher angle kappa values than either the controls or the esotropic group (independent sample t-test, p < 0.001). None of the study participants had negative angle kappa values. Higher average kappa values were obtained in left eyes than in right eyes in all three groups (student t-test, p < 0.01 for all groups). This study showed that exotropic patients have higher angle kappa values when compared to esotropic patients. Ophthalmologists must take the kappa angle into account when performing a Hirschberg or Krimsky test in young and uncooperative patients in order to improve surgical results.
    Strabismus 01/2007; 15(4):193-6.
  • [show abstract] [hide abstract]
    ABSTRACT: Botulinum toxin has been used extensively in strabismus management. However, less is published regarding its use in small-angled manifest deviations or decompensating heterophorias, where an alternative to surgery is required. The aim of this review is to look at the use and effectiveness of botulinum toxin in managing small-angled manifest deviations, both constant and intermittent, and decompensating heterophorias. These types of strabismus can prove difficult to manage, as the angle present is often too small for surgery to be advised, but it may still cause a cosmetic or symptom-producing problem. A search of the English speaking literature was undertaken using Medline facilities as well as a limited manual search of non-Medline journals and transactions. A brief overview is provided for mechanisms of action, complications and dose effects, and diagnostic and therapeutic uses of botulinum toxin. The main reported complications are those of ptosis, induced vertical deviation and subconjunctival haemorrhage. The higher the dose, the greater the risk of complications. In small-angle strabismus, botulinum toxin is reported as particularly useful in cases of acquired and acute-onset esotropia in aiding maintenance of binocular vision. It is useful for additional management of surgically under- or over-corrected esotropia, particularly for those with potential for binocular vision. Less effect is reported in primary exotropia versus primary esotropia. It is the management of choice for consecutive exotropia, particularly when patients have had previous multiple surgery and where there is a risk for postoperative diplopia. Botulinum toxin has a specific role in decompensated heterophoria, allowing the visual axes a chance to 'lock on' and subsequently maintain binocular vision. Successful outcomes are reported after 1-2 injections only but the results are best in cases of heterophoria with little near-distance angle disparity.
    Strabismus 01/2007; 15(3):165-71.
  • [show abstract] [hide abstract]
    ABSTRACT: Case report of a 15-year-old girl presenting with a left-sided Duane's retraction syndrome (DURS) in combination with ipsilateral retinal coloboma and contralateral microphthalmia. Abduction limitation as well as narrowing of the palpebral fissure and globe retraction during attempted adduction (type I DURS) was demonstrated in the left eye. Additionally, a retinal coloboma was observed in the nasal inferior quadrant of the left eye. No other somatic or developmental abnormalities were observed and karyotypic analysis was normal. This is the first case of non-syndromic unilateral DURS associated with a contralateral major ocular malformation. This unusual clinical combination probably arose from the embryonic action of an eye-specific disruptor.
    Strabismus 01/2007; 15(2):113-7.
  • [show abstract] [hide abstract]
    ABSTRACT: We examined the effects of the Harada-Ito procedure on static and dynamic alignment in an adult with acquired bilateral superior oblique palsy (SOP). 3D eye movements were recorded before and six weeks after a bilateral Harada-Ito procedure. Superior oblique muscle (SOM) size and contractility were assessed with orbital imaging. On MRI, the left SOM was smaller than the right. Little contractile thickening was present in down gaze for either eye. Preoperatively, the patient had a hypertropia: 1.9 degrees right hypertropia (at down 20 degrees , left 20 degrees ) and 6.4 degrees left hypertropia (at down 20 degrees , right 20 degrees ). Postoperatively, the vertical tropia in all positions was < 1 degrees . Listing's primary position rotated toward straight ahead for the RE but was unchanged for the LE. Postoperatively, for 40 degrees upward saccades peak dynamic intrasaccadic extorsion decreased by 2.2-3.2 degrees for both eyes and for 40 degrees downward saccades by 2.3-3.6 degrees for the RE but was unchanged for the LE. Saccade conjugacy improved and post-saccadic drift lessened for all vertical saccades. The Harada-Ito procedure produced striking improvements in static and dynamic alignment in bilateral SOP. Some changes were binocular (decreased post-saccadic drift, improved saccade conjugacy, less dynamic extorsion for upward saccades) but others were much greater in the less paretic eye (torsional gradients from up to down gaze, less dynamic extorsion for downward saccades). Both central adaptive and peripheral mechanical changes explain these findings. Our results also imply that the Harada-Ito procedure has more effect when there is residual function of the SOM.
    Strabismus 01/2007; 15(3):137-47.
  • [show abstract] [hide abstract]
    ABSTRACT: This study investigated the ultrastructural changes in extraocular muscles under which radioactive plaques had been placed for the treatment of uveal melanoma. At the time of plaque removal, biopsies were taken from four horizontal recti that had been left in situ over plaques and from one lateral rectus muscle that had been disinserted before brachytherapy. Normal lateral recti from enucleated eyes were used as controls. Iodine-125 seeds were used with a mean total activity of 54.04 mCi, remaining for an average of 149.62 hours over the sclera. Muscles that had been left in situ over the radioactive plaques demonstrated a focal decrease in muscular tissue and increased fibroblasts and collagen. Electron microscopy showed increased collagen, loss of sarcoplasmic reticulum and swollen mitochondria. The disinserted muscle in the plaque group appeared unaffected. Despite the theoretical shielding properties of plaques, leaving an extraocular muscle over the plaque may lead to several non-specific ultrastructural changes.
    Strabismus 01/2007; 15(2):103-9.
  • [show abstract] [hide abstract]
    ABSTRACT: Congenital fibrosis of the extraocular muscles includes a wide spectrum of phenotypically heterogeneous disorders involving a single or multiple muscles. We present a case of congenital fibrosis of the inferior rectus associated with ipsilateral high myopia. First we tried to treat the hypotropia with inferior rectus weakening and superior rectus strengthening procedures, but this failed, so we proceeded with an ocular sling with fascia lata and a vertical Hummelsheim procedure. Hypotropia improved completely after the last operation and some degree of upward movement appeared. It seems that in a highly myopic globe with fibrotic muscles, classical methods for the correction of deviation may have poor response and more innovative procedures may be required to correct the deviation.
    Strabismus 01/2007; 15(3):157-63.
  • [show abstract] [hide abstract]
    ABSTRACT: We report the case of a 20-year-old female who developed progressive esotropia, which was associated with low myopia and restricted extraocular movements.
    Strabismus 01/2007; 15(2):111-2.

Related Journals