Our Summary

The research paper looks into the success rate of natural healing and surgery in patients suffering from both cortical visual impairment (CVI), a form of visual impairment caused by the brain’s inability to comprehend visual information, and strabismus, a condition where the eyes don’t align with each other when looking at an object.

The research was based on a review of medical records of patients suffering from these conditions over a period of 10 years. Patients were grouped into four categories based on their condition: those who naturally got better, those who didn’t improve but didn’t have surgery, those who had successful surgery with minimal alignment issues, and those who had surgery but still had substantial alignment issues.

Out of 70 patients, 16% naturally got better, 38% didn’t improve but didn’t have surgery, and 46% had surgery. Among the patients who underwent surgery, 56% had successful results with minimal alignment issues, 28% had moderate alignment issues, and 16% had significant alignment issues.

The research found that the patients who didn’t have surgery were generally older. However, there was no significant difference in the age at which patients had surgery or naturally got better, the type of strabismus, or the underlying cause of the CVI.

The study concluded that only a small percentage of patients naturally got better. However, surgery was found to be reasonably successful, with only a small percentage of patients having significant alignment issues post-surgery. Therefore, surgery can be a good option for patients suffering from CVI and strabismus.

FAQs

  1. What percentage of patients experienced spontaneous resolution of strabismus in the study?
  2. What was the success rate of strabismus surgery in patients with CVI?
  3. Were there any significant differences between the groups in terms of age at surgery or spontaneous resolution, type of strabismus, or underlying cause of CVI?

Doctor’s Tip

A helpful tip a doctor might tell a patient about strabismus surgery is to carefully follow all pre-operative and post-operative instructions provided by the surgeon. This may include specific guidelines for medications, activities, and follow-up appointments to ensure the best possible outcome and minimize the risk of complications. It is also important to communicate any concerns or changes in symptoms to the doctor promptly.

Suitable For

Patients with cortical visual impairment (CVI) and strabismus are typically recommended for strabismus surgery if they do not experience spontaneous resolution of their strabismus and if the misalignment is causing significant visual impairment or discomfort. Patients who are younger at presentation may be more likely to undergo surgery, as they have more potential for visual improvement and better long-term outcomes. Patients with CVI and strabismus who undergo surgery have a good chance of achieving alignment within a reasonable range, with only a small percentage experiencing poor final alignment. Proper patient selection is key to the success of strabismus surgery in this population.

Timeline

  • Before strabismus surgery:

  • Patients with cortical visual impairment (CVI) and strabismus are evaluated by a healthcare provider.

  • Patients may undergo various tests and examinations to determine the extent of their strabismus and the underlying cause.

  • Patients may be observed without receiving surgery or may be recommended for strabismus surgery.

  • Patients who undergo surgery are selected based on proper criteria.

  • After strabismus surgery:

  • Patients who undergo surgery may experience alignment of ≤10(Δ), 11(Δ)-25(Δ), or >25(Δ) postoperatively.

  • Patients who did not undergo surgery may continue to be observed for any changes in their strabismus.

  • Patients who experience spontaneous resolution of strabismus may not require surgery.

  • Overall, strabismus surgery can be successful in properly selected patients with CVI and strabismus, with a minority experiencing spontaneous resolution and only a small percentage having poor final alignment after surgery.

What to Ask Your Doctor

  1. What is the success rate of strabismus surgery in patients with cortical visual impairment (CVI)?
  2. Am I a good candidate for strabismus surgery based on my specific case of CVI and strabismus?
  3. What are the potential risks and complications associated with strabismus surgery in patients with CVI?
  4. How long is the recovery process after strabismus surgery for patients with CVI?
  5. What are the expected outcomes of strabismus surgery for patients with CVI in terms of alignment and visual improvement?
  6. Are there any alternative treatment options to consider before deciding on strabismus surgery for my condition?
  7. How many strabismus surgeries have you performed on patients with CVI, and what is your experience with this specific population?
  8. Can you provide me with information on the specific surgical technique you plan to use for my strabismus correction?
  9. What is the long-term prognosis for my strabismus after surgery, and will I need additional treatments or follow-up care?
  10. Are there any specific pre-operative preparations or post-operative care instructions I should be aware of for strabismus surgery in patients with CVI?

Reference

Authors: Binder NR, Kruglyakova J, Borchert MS. Journal: J AAPOS. 2016 Apr;20(2):121-5. doi: 10.1016/j.jaapos.2015.12.010. PMID: 27079591