Surgical outcomes following ocular re-alignment in various types of squints

Abstract

Background: Strabismus is one of the causes for visual impairment in childhood. It affects the development of binocular single vision. Therefore, early detection and timely management of strabismus is important. Aim: This study was aimed to describe types of strabismus patients presenting to a tertiary care center and the various management modalities including the surgical outcomes of ocular re-alignment Materials and Methods: Retrospective chart analysis of all patients with strabismus in any age group over a period of 5 years. Patients with cerebral palsy were excluded from this study. Surgical outcomes were graded as good if the eyes were orthophoric post-operatively, satisfactory if there was a residual squint of less than 10 degrees, and it was considered to be a poor outcome if the patients were left with more than 10 degrees of residual squint. Results: Chart analysis of 53 cases with strabismus comprising of 33 males and 20 females was done. The mean age of patients was 25 years. Thirty-two (60%) cases had exotropia, and 14 (26%) had esotropia. Three cases were of congenital superior oblique palsy, and one case was of lateral rectus palsy. Duane syndrome type I was seen in four cases. Of the 38 (72%) patients who were advised surgical correction, only 20 individuals underwent surgery. Reasons for refusal of surgery varied from fear factor to financial constraints and a disregard for cosmesis. Surgeries had been performed on both children (7) as well as adults (13). Seventy-five percent of the operated patients had exotropia. Eighteen patients underwent single-staged surgery. Bilateral recessions were the most common type of surgery noted in this study. Fifty percent of them remained orthophoric up to one year of post-operative follow up. Conclusion: Exotropia was the most common type of strabismus observed in this study. Successful ocular re-alignment was seen in majority of the patients following a single-stage procedure. Greater effort needs to be made to educate the public on need for early diagnosis and management.