Authors : Neebha Anand, Jaya Gupta, Reena Gupta
DOI : 10.18231/j.ijooo.2020.009
Volume : 6
Issue : 1
Year : 2020
Page No : 48-54
Introduction : Incomitant strabismus typically results in intractable diplopia, blepharoptosis, ocular
motility disturbance, disturbance in pupil reaction and an unacceptable compensatory head or face posture.
A complete clinico etiological profile is necessary for identifying the underlying risk factors and etiology
pertaining to paralytic and restrictive strabismus which is imperative in prevention , early detection,
managing the etiology and timely recovery in these patients.
Objective: To study the clinico-etiological profile of patients with paralytic and restrictive strabismus in a
tertiary eye hospital.
Material and Methods: Patients reporting to a tertiary eye hospital in north India and diagnosed with
paralytic and restrictive strabismus, over a period of one year , were enrolled in the present study . Patients
were subjected to detailed ocular examination and evaluated for ocular motility or related disorders. This
included detailed clinical history, ophthalmic examination, orthoptic workup , sensory evaluation, diplopia
charting, Hess charting, slit lamp examination and fundus examination . In patients of suspected restricted
strabismus, forced duction test was performed. Relevant systemic investigations including blood pressure ,
blood sugar and lipid profile were carried out . M.R.I orbit was done in every patient. Neuroimaging was
advised in those patients where indicated.
Results: 48 patients were diagnosed with incomitant strabismus and enrolled in the study. 81.3%were of
paralytic strabismus while 18.8 % were of restrictive strabismus. In the group of paralytic strabismus, 43.8
% patients had sixth nerve palsy , 27.1% patients had third nerve palsy , 6.3% patients had fourth nerve
palsy and combined nerve palsy patients were 4.2%. Analysing the etiology, out of total patients of paralytic
strabismus, 48.7% of cases were idiopathic, 25.6% were post traumatic, 15.4% were due to microvascular
causes , 5.1% of cases were due to intracranial anomalies and rest 5.1% were due to inflammatory causes.
In restrictive strabismus group, 66.7% were congenital and rest 33.3% were acquired.
Conclusion: Our study has reflected the prevalence, distribution , etiological and clinical profile of patients
presenting with incomitant strabismus . It is helpful for ophthalmologists and other physicians in guiding
diagnosis and evaluation and is useful for proper and timely intervention and timely recovery in these
patients.
Keywords: Clinico-etiological profile, Incomitant Strabismus, Paralytic, Restrictive.