Universitas Malahayati

STRABISMUS OR MISALIGNMENT

“Common types of strabismus”

Yulia Nurchalifah S.ked

Diah Adelia Emilda S.ked
 DISCUSSION

introduction CONGENITAL ESOTROPIA CONGENITAL ESOTROPIA

ACCOMMODATIVE
PSEUDOESOTROPIA Conclusion
ESOTROPIA
 Introduction

Definison

Misalignment of the eyes is called strabismus (or squint). Common types of strabismus
Misalignment means that the eyes are not lined up to look at
of the dozens of different types of
the same thing. In every case of strabismus or misalignment,
strabismus, three types are seen much
one eye is fixed on what the person intends to look at (the
more commonly in the paediatric
fixing eye) and the other eye is looking at something else
population.
(the deviated eye).

Evaluation !!!
children are referred for evaluation and
treatment of early onset esotropia when, in
fact, they have pseudostrabismus related to
prominent epicanthal folds
 PSEUDOESOTROPIA
or
PSEUDOSTRABISMUS

Transient misalignment of a baby’s

eyes is very com-mon up to the age of
four months.

The appearance of strabismus is

particularly noticeable in a child’s side
gaze as the eye travels underneath the
epicanthal fold.

A simple cover test of each eyeseparately will

elicit no movement in the uncovered
eye,confirming a diagnosis of pseudoesotropia
related to epi-canthal folds.
 CONGENITAL ESOTROPIA

Congenital esotropia is much less

common than pseudo-esotropia, and
it presents as a very large angle of
esode-viation in a young child

The treatment for congenital esotropia

is surgical, con-sisting of weakening
and strengthening the
appropriateextraocular muscles.

Surgery is customarily performedaround one year of

age (3), and these children must be fol-lowed through
their amblyogenic years (up to age eight) toensure that
any preference for one eye is treated satisfac-torily with
occlusion therapy.
 ACCOMMODATIVE ESOTROPIA

The onset of accommodative esotropia

occurs betweenthe ages of 18 months
and four years, and may developacutely,
simulating a sixth nerve palsy.

Accommodative esotropia develops because of

anabnormal relationship between the converging
muscles(medial recti) and the focusing muscles
(ciliary body) at-tached to the lens inside the eye.

Children with accommodative esotropia

tend to bequite hyperopic (far sighted), and
treatment is directed atcorrecting this far
sightedness with glasses.
 INTERMITTENT EXOTROPIA

Intermittent exotropia develops

between the ages of10 months and
four years, and can be rather difficult
todetect

A classic symptom of intermittent exotropia is the

closure of one eye in bright sunlight. this happens
most frequently outdoors, the children will begin to
close one eye.

Surgery for intermittent exotropia is generally per-

formed around the age of four years when
adequatemeasurements of the angle of deviation can be
obtained. Surgery consists of weakening and
strengthening appropriate extraocular muscles, and,
generally, glasses andexercises are of no particular value.
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CONCLUSIONS

Cover testing will detect any type of strabismus, andshould be performed routinely
both at far and near distances. A single cover test means covering one eye
(eg,placing one hand on the child’s head and using the thumbas an occluder), and
watching for movement in the oppo-site eye. If the eyes are satisfactorily aligned,
there will beno movement whatsoever in one eye when the other iscovered. Alternate
cover test involves moving the occluderfrom one eye to the other, and watching the
eye that hasjust been uncovered; there should be no movement whilethis manoeuvre
is undertaken. Children who are ambly-opic in one eye will lustily resist any attempts
to covertheir good eye, indicating an inequality of vision andprompting a
referral to an ophthalmologist
Thank You