Therapeutic outcomes in patients with post-traumatic strabismus from a tertiary center in Chile

Abstract

Purpose: Strabismus (heterotropia) is one of several possible complications of ocular traumatic injury. This condition is associated with a decreased quality of life. The purpose of this study is to present the functional outcomes of a series of 35 patients presenting with strabismus secondary to eye trauma. Methodology: Retrospective study. Treatments for each type of post-traumatic ocular lesion were categorized, which included conservative management by clinical observation; use of a lens with prismatic addition; intramuscular injection of botulinum toxin; or surgery. The strabismus conditions were evaluated prior to the treatment and six months after the last treatment had been received. The rate of therapeutic success, defined as ±10 PD (prism diopters) was assessed. Results: The orbital injuries that most commonly caused strabismus were found to be orbital fracture, penetrating eye injury and direct muscle trauma. All cases of direct muscle trauma received surgical treatment; 54% of orbital fractures resolved spontaneously during clinical observation, whereas 38% required surgery. Three cases of penetrating eye injury were observed and all were resolved surgically. The rate of therapeutic success was 88.57%. A single treatment was sufficient in 88.6% of all cases. Conclusions: Non-surgical therapeutic clinical observation is sufficient in a significant percentage of cases because a large number of patients tend to spontaneous recovery. Additional techniques, such as treatment with botulinum toxin, can play a useful complementary role. Surgical intervention, assessed on a case by case basis, also proved to be highly effective in the minority of cases where it was required.