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Purpose
To report factors associated with preoperative squinting, defined as transient eye closure in bright light, and photophobia and the factors affecting improvement of these symptoms postoperatively in intermittent exotropia.
Methods
In this retrospective study, patients (N = 99) were divided into groups according to the presence (n = 54) or absence (n = 45) of preoperative squinting and the presence (n = 64) or absence (n = 35) of photophobia. Clinical characteristics, including overaction or underaction of the oblique muscle and fundus intorsion and extorsion, were compared between the two groups. The squinting and photophobia groups were further categorized into two subgroups each according to postoperative improvement. The extended list of characteristics, including the duration from onset to surgery, postoperative angle of deviation, and fusion, was compared between the two subgroups.
Results
Preoperatively, 54 (54.5%) and 64 (64.6%) patients had squinting and photophobia, respectively. The coincidence of squinting and photophobia was marginally significant (p = 0.05). Postoperatively, squinting and photophobia disappeared in 64.8 and 59.4% of the patients, respectively. The photophobia group had a younger onset age of strabismus than the nonphotophobia group (39.3 vs. 56.4 months; p = 0.03). Good fusional status at the near range was more common in the nonsquinting group than in the squinting group (74.3 vs. 47.6%; p = 0.02). Superior oblique overaction was significantly more common in the squinting group than in the nonsquinting group (11.1 vs. 0%; p = 0.03). Early surgical correction and successful outcomes were associated with squinting improvement (p = 0.001 and p = 0.02, respectively).
Conclusions
More than 50% of patients with intermittent exotropia had squinting or photophobia, and approximately 60% of symptomatic patients experienced improvement postoperatively. The onset of strabismus, near fusion, superior oblique overaction, and fundus intorsion were related to these symptoms. Early surgery and successful eye position realignment were beneficial for improving squinting postoperatively.
Vision therapy is well worth the response, time and effort. Our Son had a hard time focusing and writing neatly. After vision therapy Seth could complete a task in half the time if previously took. His abilities to focus improved greatly and so did his handwriting.
Also, he was better at listening. As a parent, we wanted learning to be fun for our Son, and vision therapy made this possible.
Vision Therapy is well worth the expense, time and effort. Our son had a hard time focusing handwriting neatly. After vision therapy Seth could complete a task in half the time it previously took his abilities to focus and improved greatly and so did his handwriting.
Also, he was better at listening. As a parent you wanted learning to be fun for our son and vision therapy made this possible.
Vision Therapy has given or son the tools he needs to be able to scan and read the written word more effectively and efficiently.
He love working with John and these working sessions give him the motivation to gladly work on his homework assignments.
It amazed us to see the difference in the tracking of his eyes and along a line of it's from the beginning to the end of the treatment.
Dr. McBryar , Kristen and John are all marvelous and we would recommend them to anyone I only wish that we would have found them sooner!
Prior to coming to the institute for vision development my son complained of daily headaches. Therapy has eliminated his headaches completely. I love knowing my son is able to learn pain-free for the rest of his life because of the work that has been done over just a few weeks in this office. He he absolutely loved coming that didn't even feel like going to a doctor or therapy. We are grateful for the relief he was able to find by coming here.
Thank you!
Seems much less frustrated with life
Reads non-stop and fast
Spelling abilities have been hugely improved
Seems much more confident
Thank You!!!
When we first came to the practice, my son did not have huge issues, but lots of small ones- trouble with reading, sports (hitting the baseball consistently), coordination, etc- that were not easily detectable,but when put together presented issues. The staff here were all very professional and loving towards him. While I was concerned in the reading, my son was concerned with the athletic side. Seeing improvement night off the bat gave him confidence that i have nor seen in him and made him want to not only Come to therapy, but also made him want to work hard. He has surpassed his grade level and above in reading and hit his first home run this year! Thank you!!!
Is foggy vision troubling you? Let our experienced optometrist restore your sight – book an appointment today and see the […]
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