Clinical risk factors and management of consecutive strabismus

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Original Article

Author Details : Reena Gupta*, Jyoti Deswal, Seemanchal Goel, Chekitaan

Volume : 5, Issue : 4, Year : 2019

Article Page : 243-250

https://doi.org/10.18231/j.ijooo.2019.056

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Abstract

Material and Methods: The study was conducted at Pediatric Ophthalmology and Strabismus clinic at
our tertiary care institute PGIMS, Rohtak. Patients who developed consecutive tropia after squint surgery
for horizontal strabismus from April 2015 to August 2016 were enrolled. Continued esodeviation after
surgery for exotropia was termed as consecutive esotropia and post-operative exodeviation present even 2
weeks after surgery for esotropia was termed as consecutive exotropia. The patients were followed up for
at least 3 months. Ocular movements, preoperative deviation (PBCT), presence of vertical deviation, DVD,
A-V patterns was noted, AC/A ratio, sensory status by Worth Four Dot Test and Titmus test. Immediate
post-operative deviation was measured. Follow-up was done at 2 weeks, 6 weeks, 3 months and 6 months.
Results: There were a total of 92 patients who underwent squint surgeries for horizontal strabismus. 12
patients developed consecutive squint. Out of 12 patients, 10 patients developed consecutive exotropia and
2 patients developed consecutive esotropia. The mean pre-operative deviation of resolved cases in both the
groups was 458.16PD for near and 42.58.66PD for distance and the mean pre-operative deviation of
unresolved cases in both the groups was 39.1610.68PD for near and 38.336.83PD for distance.
Discussion: In our study, the incidence of consecutive squint was 13%. Out of which 10.86% had
consecutive exotropia and 2.17% had consecutive esotropia. The patients who developed consecutive squint
had infantile esotropia, infantile exotropia, partially accommodative esotropia and non- accommodative
acquired esotropia. Amongst consecutive exotropias group, 40% cases resolved while in consecutive
esotropia group, 50% resolved.
Conclusion: Consecutive squint is a complication of squint surgery which can develop immediately after
surgery or years later. Taking care of the errors during measurement of pre-operative deviation improves
the success of surgical outcomes.

Keywords: Consecutive squint, Horizontal strabismus, DVD, Esodeviation, Exodeviation, Consecutive esotropia, Consecutive exotropia.

How to cite : Gupta R, Deswal J, Goel S, Chekitaan, Clinical risk factors and management of consecutive strabismus. IP Int J Ocul Oncol Oculoplasty 2019;5(4):243-250

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