On the basis of lack of consensus for the treatment of strabismus in children with developmental delay, the authors reviewed the literature to provide information on the topic and present results from their clinical experience. From the review, they include cerebral palsy, Down’s syndrome, hydrocephalus and William’s syndrome. A high prevalence of strabismus is reported with variable surgical results along with some recommendations to reduce surgical dose. From their clinical experience, they report on 183 cases seen over a 20-year period; 101 males and 82 females with mean age at surgery of 3.7 years (range six months to 15 years). Mean follow-up was 3.2 years. The cases comprised of 44 with Down’s syndrome, 40 fetal alcohol syndrome, 36 William’s syndrome, nine fragile X, 12 Angelman syndrome, 11 Cohen syndrome and 31 with cerebral palsy. At three months follow-up, 84% of those having surgery for esotropia had a deviation <8PD, 8% were under-corrected and 8% over-corrected. Sixty percent of those having surgery for exotropia had a deviation <8PD, 35% were under-corrected and 5% over-corrected. By 18 months follow-up, of those with esotropia surgery, 54% had a deviation <8PD, 3.5% were under-corrected and 43% over-corrected. For exotropia, 22.5% had a deviation <8PD, 75% were under-corrected and 2.5% over-corrected. Variable results were shown with increased residual deviation after longer follow-up for exotropia and increased over-corrected for esotropia. The authors confirm a high prevalence of strabismus in children with developmental delay with surgical outcomes that are difficult to predict.
High prevalence of strabismus and variable surgical success in children with developmental delay
Reviewed by Fiona Rowe
Surgical treatment of strabismus in children with development delay: a review of the literature and results of personal experience.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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