Our Summary

This study looked at long-term outcomes of strabismus (a condition where the eyes do not properly align with each other) in children who were treated for aphakia (absence of the lens in the eye) as infants. The research found that a high proportion (88%) of the children developed strabismus by the age of 10.5 years. Initially, the most common type of strabismus was esotropia (eyes turning inwards), but by age 10.5, exotropia (eyes turning outwards) was more common. Nearly half of the children had undergone surgery for strabismus, with 35% achieving a small degree of misalignment. The study found strabismus was just as common in children treated with contact lenses as those who received lens implants. Children who had better vision at age 10 were more likely to have better eye alignment. The researchers suggest caution in early management of esotropia in these children due to the later emergence of exotropia.

FAQs

  1. What is the most common type of strabismus found in children who were treated for aphakia as infants?
  2. Does the study suggest that strabismus is more common in children treated with contact lenses or lens implants?
  3. What is the recommendation from the researchers regarding the early management of esotropia in these children?

Doctor’s Tip

A doctor may advise a patient undergoing strabismus surgery to follow post-operative care instructions carefully, including using prescribed eye drops and avoiding activities that may strain the eyes. They may also recommend scheduling follow-up appointments to monitor progress and ensure the best possible outcome. Additionally, the doctor may discuss the importance of ongoing vision therapy or exercises to help improve eye alignment and coordination after surgery.

Suitable For

Patients who are typically recommended strabismus surgery include:

  1. Children with strabismus that is causing significant visual impairment or affecting their quality of life.
  2. Adults with strabismus that is causing double vision or cosmetic concerns.
  3. Patients with strabismus that is not responsive to other forms of treatment, such as vision therapy or prism glasses.
  4. Patients with strabismus that is causing other eye health issues, such as amblyopia (lazy eye) or eye strain.
  5. Patients with strabismus that is worsening over time and impacting their ability to perform daily tasks or activities.

Timeline

Before strabismus surgery:

  • Patient may notice misalignment of their eyes
  • Patient may experience double vision
  • Patient may have difficulty with depth perception
  • Patient may undergo a thorough eye examination and evaluation by an ophthalmologist
  • Patient may try other treatments such as glasses or vision therapy before considering surgery

After strabismus surgery:

  • Patient will have a recovery period where they may experience discomfort, redness, and swelling in the eye area
  • Patient will need to follow post-operative care instructions, which may include using eye drops or ointments
  • Patient may need to wear an eye patch or use special glasses to help with vision alignment
  • Patient will attend follow-up appointments with their ophthalmologist to monitor progress and make any necessary adjustments
  • Patient may experience improved eye alignment and vision, leading to better quality of life and self-confidence.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with strabismus surgery?
  2. How successful is strabismus surgery in correcting eye alignment?
  3. What is the recovery process like after strabismus surgery?
  4. Are there any alternative treatments for strabismus that I should consider?
  5. How long will the effects of strabismus surgery last?
  6. Will I need to wear glasses or use eye drops after strabismus surgery?
  7. How many strabismus surgeries have you performed, and what is your success rate?
  8. What is the expected outcome of strabismus surgery in my specific case?
  9. Are there any lifestyle changes or restrictions I should be aware of after strabismus surgery?
  10. How soon after strabismus surgery can I expect to see improvements in my eye alignment?

Reference

Authors: Bothun ED, Shainberg MJ, Christiansen SP, Vanderveen DK, Neely DE, Kruger SJ, Cotsonis G, Lambert SR; Infant Aphakic Treatment Study. Journal: J AAPOS. 2022 Aug;26(4):174.e1-174.e4. doi: 10.1016/j.jaapos.2022.05.003. Epub 2022 Jul 14. PMID: 35843488