Search

Aim: The purpose of this study was to assess the prevalence of strabismus and nystagmus and to analyse associated factors in preterm and full-term infants in adulthood., Methods: The Gutenberg Prematurity Eye Study is a retrospective cohort study with a prospective ophthalmological examination of participants born preterm and full-term (aged 18-52 years). Perinatal data were carefully assessed for risk factors and comprehensive ophthalmological examinations were conducted. The association between strabismus and nystagmus was assessed by analysing 16 different perinatal and actual risk factors in multivariable analysis. Participants were grouped into full-term controls (gestational age (GA) at birth ≥37 weeks), preterm participants without retinopathy of prematurity (ROP) and GA 33-36 weeks (group 2), GA 29-32 weeks (group 3), GA ≤28 weeks (group 4), non-treated ROP (group 5) and treated ROP (group 6)., Results: In total, 892 eyes of 450 preterm and full-term individuals (mean age: 28.6 years, SD: ± 8.6 years, 251 females) were included. Strabismus was observed in 2.1% (3/140), 6.6% (9/137), 17.4% (16/92), 11.1% (2/18), 27.1% (13/48) and 60% (9/15) of participants and nystagmus in 0.7% (1/140), 1.5% (2/137), 4.3% (4/92), 5.6% (1/18), 10.4% (5/48) and 26.7% (4/15) of participants in the respective groups. In the multivariable regression model, strabismus was associated with GA (OR=0.90; p=0.046), anisometropia ≥1.5 diopter (OR=3.87; p=0.003), hypermetropia ≥2 diopter (OR=9.89; p<0.001) and astigmatism ≥1.5 diopter (OR=2.73; p=0.017). Esotropia was more frequent than exotropia and hypermetropia/hypometropia. Most strabismus cases occurred within the first 10 years of life. The strongest predictor associated with nystagmus was perinatal adverse events (OR=15.8; p=0.002)., Conclusion: Low GA and refraction of the eye are independent risk factors for strabismus, which typically occurs in the first 10 years of life. Perinatal adverse events are the most important factors for the presence of nystagmus in adulthood., Competing Interests: Competing interests: NP receives financial support and grants from Novartis, Ivantis, Santen, Thea, Boehringer Ingelheim Deutschland GmbH & Co. KG, Alcon and Sanoculis. AKS receives research support from Allergan, Bayer, Heidelberg Engineering, PlusOptix and Novartis., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: This study investigates the prevalence of manifest strabismus and its subtypes in adulthood and analyzes the risk factors and its impact on vision-related quality of life (VRQoL)., Design: The Gutenberg Health Study (GHS) is a population-based, observational cohort study. A cross-sectional analysis of the baseline examination was conducted., Participants: Participants aged 35 to 74 years were included (n = 15  010)., Methods: All participants were examined with a comprehensive ophthalmologic and general examination including the Hirschberg corneal reflex test to detect manifest strabismus. The following risk factors were analyzed: age, sex, socioeconomic status, birth weight, maternal age at birth, anisometropia, astigmatism, spherical equivalent, low visual acuity in the worse seeing eye (≥1.3 logMAR), and cardiovascular factors, and included in multivariable logistic regression analysis. Lifetime period prevalence and point prevalence of manifest strabismus were computed, and VRQoL was compared between participants with and without strabismus., Main Outcome Measure: Strabismus prevalence., Results: A total of 14  700 participants (age, 55.0±11.1 years; 49.5% were female) were included in this analysis. The weighted prevalence of ever having strabismus was 2.9% (2.6%-3.2%), and the point prevalence for concomitant strabismus was 2.5% (2.3%-2.8%). Esotropia was twice as frequent as exotropia, and 2 participants had paralytic strabismus. Concomitant strabismus was associated with age 65 to 69 years (odds ratio [OR], 0.13 [0.05-0.39], P < 0.001); age 70 to 74 years (OR, 0.14 [0.05-0.4], P < 0.001); anisometropia (>1.0 diopters [D]: OR, 3.61 [2.32-5.62], P < 0.001; >2.0 D: OR, 6.93 [4.23-11.35], P < 0.001); astigmatism (≥1.0 D: OR, 2.09 [1.42-3.08], P < 0.001; ≥2.0 D: OR, 3.74 [2.35-5.97], P < 0.001); spherical equivalent (per diopter: OR, 1.43 [1.33-1.53], P < 0.001); and low visual acuity in the worse seeing eye (≥1.3 logMAR: OR, 21.7 [11.2-42.0], P < 0.001). VRQoL was lower in participants with strabismus compared with participants without strabismus in adjusted analysis (B = -5.96, P < 0.001)., Conclusions: Strabismus is a frequent chronic eye condition that is associated with a lower VRQoL. Individuals with anisometropia, astigmatism, and hyperopia are more likely to have strabismus. In addition, low visual acuity in the worse eye was linked to strabismus prevalence., (Copyright © 2020 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Introduction: Strabismus is a common cause for amblyopia and affected children need regular ophthalmic care. This study evaluated the frequency of ophthalmic care in children suffering from strabismus and analyzed associated factors., Methods: The data of the German Health Interview and Examination Survey for Children and Adolescents from the Robert Koch Institute (KiGGS, baseline survey 2003-2006, N = 17,640) were analyzed. Details on the presence of strabismus and the frequency of ophthalmic care were documented from information provided by the parents. Children aged 1-6 years were included. The relationship between strabismus and ophthalmic care in the previous 12 months was analyzed using multivariable logistic regression analysis and adjusted for age, sex, socioeconomic status, migration background, region and participation in regular pediatric check-ups., Results: A total of 5247 children were included in this study of which 3.0% (N = 175) were reported by the parents as suffering from strabismus. Ophthalmic care within the last 12 months was reported by 66.9% of the parents (95% confidence interval [CI] 54.7-77.2%) of children with strabismus and was more frequent compared to those without strabismus (19.7%, 95% CI 18.2-21.3%). Of the children with strabismus 33.8% had visited an ophthalmologist in the last 12 months once, 33.1% twice, 12.6% three times, 13.3% four times and 7.2% more than four times. There was a relationship between strabismus (odds ratio [OR] = 9.21, 95% CI 5.44-15.6) and ophthalmic care during the preceding year., Conclusion: In Germany approximately one third of children with strabismus did not receive ophthalmic care within the previous year. This underlines the need for improvements in ophthalmic care in children with strabismus.

Background : Recession and resection of rectus muscles for correction of strabismus in Thyroid Eye Disease (TED) is relatively unpopular as it is assumed to enhance the restriction of ocular ductions. Therefore, the purpose of this study was to compare ductions of recession only and recess/resect procedures. Methods : We retrospectively reviewed the charts of 119 patients who underwent strabismus surgery for TED from 1991 to 2015, of which 102 were included in the present study. Forty-six interventions were performed on horizontal, 56 on vertical rectus muscles; comprising 41 recess/resect surgeries for horizontal deviations, and 7 in patients with vertical strabismus. Ocular ductions and alignment were evaluated preoperatively and at 3 and 12 months postoperatively. Results : Both recessions as well as recess/resect procedures resulted in improved abduction and elevation, respectively. At the exam 3 months postoperatively, median abduction for the recession only group and the recess/resect group were 27.5° and 35°, respectively. The similar figures for elevation were 25° and 10°, respectively. Neither were statistically significant. No restricted adduction or depression was seen in the recess/resect surgeries groups with lateral or superior rectus resection. None of the patients showed unusual postoperative inflammation or conjunctival scarring. Conclusion : In this retrospective analysis, we found an equal effect on ocular ductions in patients with TED when comparing recess/resect eye muscle surgery to recess only procedures. In TED patients with large horizontal angle deviations and abduction deficit, medial rectus recession and lateral rectus resection surgery can be considered. Muscle resections in TED do not seem to have a clinically relevant risk to increase the restriction of ocular ductions but rather improve ductions in the restricted directions of gaze.

Background: To estimate the effect of strabismus (squinting) on mental health and health-related quality of life aspects in children and adolescents., Methods: Data from the German Health Interview and Examination Survey for Children and Adolescents KiGGS (2003-2006 baseline survey; N = 14,835, aged 3 to 17 years, 49% girls) were examined. The presence of strabismus was derived by parental questionnaire, and health-related quality of life and mental health were investigated with the KINDL-R and Strengths and Difficulties Questionnaire. Associations between strabismus and outcomes were analyzed using multivariable linear and logistic regression models., Results: Of 12,989 children without missing data, 579 children (4.5% of the sample) were reported to have strabismus. Children with strabismus had lower scores in the parent-reported KINDL-R total scale (adjusted beta = - 1.02; 95%CI: -1.86 to - 0.18; p = 0.018) and sub-scale 'friends' (adjusted beta = - 2.18; 95%CI: -3.56 to -0.80; p = 0.002) compared to children without strabismus. The presence of strabismus was also associated with more mental health problems like 'hyperactivity/inattention' (adjusted OR = 1.50; 95%CI: 1.14 to 1.98; p = 0.005), and 'peer problems' (adjusted OR = 1.35; 95%-CI: 1.05 to 1.74; p = 0.018) as reported by parents., Conclusions: Strabismus in children and adolescents is associated with lower health-related quality of life.

Objectives: To estimate the prevalence of strabismus in children and adolescents in Germany and to determine the associated risk factors, particularly those related to early childhood development., Methods: In the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, baseline survey 2003 to 2006, N = 17,640, 49.1% girls), the presence of strabismus and potential risk factors were derived using parental questionnaires. The analyses were performed using the KIGGS public use file. The following relevant factors were analyzed: smoking during pregnancy, gestational age at birth, birth weight, medical problems within the first four weeks of life, and officially confirmed disability. Associations with strabismus were evaluated using multivariable logistic regression analysis. Odds ratios and 95% confidence intervals [95%-CI] were calculated and adjusted for age, sex, socio-economic status, migrational background, and participation in regular pediatric checkups., Results: The prevalence of strabismus was estimated to be 4.1% [3.7-4.5]. Boys had a slightly lower prevalence (3.7%; [3.3-4.2%]) compared to girls (4.4%; [3.9-5.0%]; p value > 0.05). After adjusting for confounders, strabismus was found to be significantly associated with smoking during pregnancy (OR = 1.38; [1.08-1.78]), gestational age (OR = 0.91 per week; [0.86-0.96]), medical problems within the first four weeks of life (OR = 1.29; [1.01-1.65]) and disability (OR = 4.33; [2.81-6.67]), but not with other risk factors under study., Conclusions: In Germany, strabismus is among the most prevalent chronic eye conditions. Former preterm infants and disabled children and adolescents are at greater risk.