PURPOSE: We assessed the relationship between the surgical outcome of intermittent exotropia and initial postoperative alignment by checking it on the first postoperative day or the day of strabismus surgery. METHODS: Seventy-three patients with intermittent exotropia underwent bilateral lateral rectus recession or unilateral medial rectus resection and lateral rectus recession. Thirty-two patients had their postoperative alignment checked on the day of surgery, and forty-one patients were checked on the first postoperative day. Success was defined as sustained alignment six months postoperatively from esotropia 10PD to exotropia 10PD. Overcorrection was defined as esotropia greater than 11PD, and undercorrection was exotropia greater than 11PD. We assessed the relationship between the alignment on the day of surgery or on the first postoperative day and also at six months postoperatively, as well as the success rate according to the initial postoperative alignment. RESULTS: There was a statistically significant relationship between alignments on the day of surgery or on the first postoperative day and those at six months postoperatively (p<0.001, p<0.001). The deviation on the first postoperative day had a greater correlation coefficient compared to the deviation on the day of the operation (Pearson correlation coefficient=0.704, and 0.593, respectively). The alignment of overcorrection ranged from 11~20PD on the day of surgery, and on the first postoperative day it produced a relatively high success rate (p=0.016, p=0.035). There was no statistically significant difference in the success rate between the two types of surgery (p=0.832). CONCLUSIONS: The alignment on the day of surgery showed a high correlation to the outcome on the sixth postoperative month in intermittent exotropia patients. The initial postoperative overcorrection of 11 to 20PD on the day of surgery and on the first postoperative day resulted in the best long-term outcomes.
Esotropia ; Exotropia* ; Humans ; Strabismus

There are many factors that influence the response of strabismus surgery. This study was undertaken to evaluate the influence of axial length on the response to strabismus surgery. Axial length was determined preoperatively on 156 non-paralytic horizontal strabismus patients undergoing strabismus surgery from February, 1993 to April, 1994. The mean axial length in all patients was 22.29+/-1.35mm. In esotropia the mean axial length was 21.24+/-1.12mm and in exotropia the mean axial length was 22.68+/-1.23mm. A statistically significant inverse correlation was found between axial length and surgery response (prism diopters per millimeter of recuts recession) in esotropic patients (R=-0.51 p=0.0006). Especially in aquired esotropia, a more significant correlation was found between axial length and surgery respinse (R=-0.73 P=0.0001). The relationship in esotropia was linear and could be written as the approximate regression formula : surgery response=9.51-0.29* axial length (R=-0.454 P=0.03). However, a poor correlation was found between axial length and surgery response in exotropia. Therefore it is regraded as being effective that the amount of recession in esotropia should be graduated according to axial length.
Esotropia ; Exotropia ; Humans ; Strabismus*

A cyclic squint is a rare, interested in ocular motility disturbance. It appears regular and alternate-day rhythmic cycle, most frequently at 48 hours The cyclic squint was reviewed approximately 50 Cases in literatures since it was first reported by Burian in 1958. These all was presented with cyclic ESOTROPIA but authors have not found a description of cyclic EXOTROPIA as described here. The biological clock mechanism which induces a cyclic squint is unknown. This case had recession of the bi-lateral recti and obtained constant orthophoria.
Biological Clocks ; Esotropia ; Exotropia* ; Strabismus

The heterophoria and fusional amplitude were measured on 100 normal Korean peoples, aged from 5 to 66 years. 1. The normal value of the horizontal and vertical phoria were measured by phorometer at 6m distance. They were revealed that the frequency of the heterophoria were 95% of horizontal phoria, 26% of vertical phoria and 5% of orthophoria. And there were no statistical correlation between age, sex and heterophoria. 2. The normal value of the convergence, divergence, vertical and cyclovergence fusioanl amplitude were measured with major amblyoscope. And the correlation between horizontal phoria and horizontal fusional amplitude, age and fusional amplitude were also studied. The results were as follows. The normal value of convergence fusional amplitude revealed significantly higher value than other datas which measured by rotary prism or other methods, but divergence and vertical fusional amplitude were almost same value than others. The difference seemed due to using interesting picture slide in my experience which stimulate accommodative factor. The correlation between horizontal phoria and horizontal fusional amplitude revealed that smaller convergence amplitude in exophoria, and larger in esophoria, but no significant relationship between divergence amplitude and horizontal phoria were noted. Also there were no significant correlation between age and fusional amplitude.
Esotropia ; Exotropia ; Reference Values ; Strabismus

We Performed an epidemiologic survey for strabismus among primary school-children in order to investigate the number of strabismus from March 1995 to February 1996. Cover-uncover test and prism cover test were used. The results were as follows:1. Out of 9054 1st grade primary school-children examined, 322(3.56%) were found as strabismus. 2. 322 cases of strabismus include 262(81.4%)exodeviation and 60(18.6%) esodeviation. 3. Alternating type and monocular type strabismus have no difference both in exotropia and esotrapia. 4. In exotropia and esotropia, no sexual predilection was found. 5. Most portion of deviation angle distribute between 11 to 20 prism diopter. 6. The difference of number of strabismus between big cities and small cities was statistically insignificant(p>0.05).
Epidemiology ; Esotropia ; Exotropia ; Korea* ; Strabismus*

Cyclic strabismus is now well recognized, but remains a rare entity. This heterotropia represents an interesting ocular motility problem in which the ocular deviation is present on a rhythmic basis, usually a 48 hour cycle. On the strabismic day, constant heterotropia is large and associated with suppression and no diplopia. On the nonstrabismic day, no deviation or only a small heterophoria is present with good binocular function. Most of these strabismus were presented with esotropia, but in our case, the pattern of deviation is cyclic exotropia. This is a very rare and unique feature.
Diplopia ; Esotropia ; Exotropia* ; Strabismus ; Telescopes

Cyclic esotropia is a very rare and specific entity. Cyclic esotropia is sometimes developed in a patient following strabismus surgery for intermittent exotropia. The term of 'consecutive cyclic esotropia' was suggested for this clinical entity. Three cases of consecutive cyclic esotropia have been reported in U.S.A., Canada and Japan, and only one case has been reported in Korea. We experienced two cases of consecutive cyclic esotropia which developed 10 months and 1 year after strabismus surgery for intermittent exotropia at our hospital. The patients underwent bimedial rectus recessions and results are uniformly good, with straight eyes and fusion. The cyclic pattern does not recur. We report these patients with a review of the literature.
Canada ; Esotropia* ; Exotropia* ; Humans ; Japan ; Korea ; Strabismus*

PURPOSE: To investigate clinical features in patients with orthophoria over three years after surgical correction of intermittent exotropia. METHODS: Sex, age at onset and surgery, preoperative and postoperative angles of ocular deviation, type of surgery, associated disorders, and preoperative and postoperative binocular sensory status were retrospectively investigated in 27 patients with orthophoria or ocular deviation under 8 prism diopters (PD) at least three years after surgical correction of intermittent exotropia. RESULTS: The mean age at surgery was 5.3+/-4.8 years (range, 2 to 27 years). Ten patients (37.0%) were younger than four at the time of the operation, while 17 (63.0%) were four or older. The mean size of the preoperative exodeviation at distance and near was 27.4+/-7.3PD (range, 15 to 45PD) and 28.2+/-8.5PD (range, 12 to 50PD), respectively. On the first postoperative day, 7 patients (26.0%), 13 patients (48.1%), 6 patients (22.2%), and 1 patient (3.7%) showed esophoria (9 to 15PD), esophoria (under 8PD), orthophoria, exophoria (under 8PD), respectively. Twenty-two patients (81.5%) developed orthophoria within 2 months after surgery. After three years following the operation, 16 patients (59.3%) had developed orthophoria, while 11 patients (40.7%) showed exophoria within 8PD. CONCLUSIONS: At the first postoperative day, most patients (74.1%) were overcorrected, while the rest (25.9%) were either undercorrected or orthophoric. Our investigation showed that patients not initially overcorrected can maintain good results. None of the patients had an A or V pattern of strabismus or dissociated vertical deviation with exodeviation before surgery.
Esotropia ; Exotropia* ; Humans ; Retrospective Studies ; Strabismus ; Telescopes

PURPOSE: Study by result analysis the proper recession amount according to the deviation angle after unilateral lateral rectus recession in exodeviation. METHODS: A retrospective analysis data from 139 patients who underwent unilateral lateral rectus recession with 15~24PD exodeviation and monitored for 12 months or longer was performed. The analyzed patients were divided into 7.5 mm, 8 mm, 8.5 mm, 9 mm, 9.5 mm groups according to the surgical amount of recession and 15~18PD, 19~20PD, 21~24PD groups according to the deviation angle. The strabismus surgery and results analyses were based on distance deviation. Alignment within 4PD of esodeviation and 10PD of exodeviation was considered a surgical success. RESULTS: The success rates were 53.8% for the 15~18PD group and 40% for the 19~20PD group in the 7.5 mm recession group, 77.7% for the 15~18PD group and 66.7% for the 19~20PD group and 63.6% for the 21~24PD group in the 8 mm recession group, 100% for the 15~18PD group and 81.2% for the 19~20PD group and 72.7% for the 21~24PD group in the 8.5 mm recession group, 83.3% for the 15~18PD group and 85.7% for the 19~20PD group and 83.3% for the 21~24PD group in the 9 mm recession group, 100% for the 19~20PD group and 76.9% for the 21~24PD group in the 9.5 mm recession group at 1 year postoperative. The rates of -1 abduction limitation were respectively 3.1%, 12% and 21.4% in the 8.5 mm, 9 mm and 9.5 mm recession groups and the rate of -2 abduction limitation was 14.3% in the 9.5 mm recession group at 1 year postoperative. CONCLUSIONS: Considering the success state and abduction limitaions, the proper surgical amount of recession is 8.5 mm in the 15~18PD group and 9 mm in the 19~20PD and 21~24PD groups.
Esotropia ; Exotropia* ; Humans ; Retrospective Studies ; Strabismus

The authors analysed the interpupillary distance and the distance between optical centers in 200 spectacles wearers. The results were as follows; 1. Among the 200 glasses wearers, the cases of hospital prescriptions were 44 persons and the cases of optical shops prescriptions were 156 persons. 2. Hyperopic glasses wearers were 26 persons and myopic glasses wearers were 174 persons. 3. The distance between optical centers was coincided to the interpupillary distance in 26 persons and discrepant in 174 persons. 4. In 115 eyes the prismatic effects were more than 0.5 prism diopter, and maximal prismatic effect was 5.78 prism diopters. 5. The evaluation of the induced horizontal phoria showed that 119 persons had the induced esophoria and 55 persons had the induced exophoria. In 58 persons induced phoria were more than 1 prism diopter. Maximal induced esophoria was 11.55 prism diopters and maximal induced exophoria was 4.30 prism diopters.
Esotropia ; Exotropia ; Eyeglasses* ; Glass ; Humans ; Prescriptions ; Strabismus