Esotropia, exotropia oppositely affect need for strabismus surgery in ocular trauma cases

NASHVILLE, Tenn. — The presence of any initial esotropia was negatively correlated with the need for strabismus surgery in patients with both ocular trauma and diplopia, whereas initial exotropia correlated positively, according to a poster presented at the American Association for Pediatric Ophthalmology and Strabismus meeting.

In a retrospective review of 265 patients at the University of Iowa, Tyler B. Risma, MD, and colleagues assessed ocular misalignment in patients with diplopia after orbital trauma to identify presenting features that predispose patients to needing strabismus surgery and to identify the type of surgery needed.

Of the patients, 45% underwent no surgery, 35% had only orbital fracture repair and 20% underwent strabismus surgery, according to the poster. Vertical recti or oblique muscles were involved in 68% of the strabismus surgery cases.

Demographics were similar among the groups, and no statistically significant correlations were seen in fracture location or ocular misalignment predictive of the need for strabismus surgery.

Those presenting with exotropia were more than three times more likely to need strabismus surgery, while those presenting with esotropia were 75% less likely to undergo strabismus surgery.

“It is difficult to explain the apparent protective benefit of esotropia against strabismus surgery or positive correlation of exotropia with strabismus surgery,” the authors wrote, while also recognizing that a larger data set could alter their conclusions. – by Patricia Nale, ELS

Reference:

Risma TB, et al. Diplopia after orbital trauma: Predicting need for surgical treatment. Poster 13 presented at: American Association for Pediatric Ophthalmology and Strabismus annual meeting; April 2-6, 2017; Nashville, Tenn.

Disclosure: Risma and colleagues report no relevant financial disclosures.