الفهرس | Only 14 pages are availabe for public view |
Abstract Intermittent distance exotropia X(T) is a form of early onset childhood strabismus, affecting around 32 per 100,000 of children aged under 19 years. It comprises periodic divergent misalignment which is initially present on distance fixation, or during periods of tiredness or inattention alone, but may become more frequent and be present on near fixation, eventually leading to constant exotropia in some cases. Constant exotropia following de-compensation of intermittent to constant exotropia causes loss of near stereopsis, with suppression or panoramic vision and amblyopia, or diplopia, depending on age of onset. Despite the incidence of amblyopia in cases of X (T) is uncommon, amblyopia treatment may improve the control of the squint. Treatment of amblyopia consists of correcting the optical deficit (wearing the necessary spectacle prescription) and often forcing use of the amblyopic eye, by patching the good eye. Current clinical guidelines based on expert opinion advise the initiation of amblyopia treatment before surgical correction of strabismus. Correction of the underlying refractive error is the initial step towards management of X(T). Providing clear retinal images may promote fusion and lead to a reduction or elimination of the deviation in some cases. Part time patching has found some use in very young children. It is a passive anti-suppression technique as opposed to the active techniques involving diplopia awareness. Part time patching of the non-deviating eye for four to six hours daily may convert an intermittent exotropia to a phoria. Although the benefit is usually Summary 55 temporary, occlusion can be used to postpone surgical intervention in responsive patients. Our study included 50 children of both genders diagnosed with amblyopia and X (T) who divided into 3 groups: group (A): 20 patients who have bilateral amblyopia have been given spectacles. group B: 13 patients who have insignificant refractive errors have been given part time patching therapy .group C:17 patients who have unilateral amblyopia with significant refractive errors have been given spectacles and part time patching therapy. The mean age of the studied children 6.32 years. 50% were males and 50% were females. 19(38%) children had basic extropia, 14(28%) had pseudo extropia and 17(34.0) had true extropia. Visual acuity improved after treatment in 45(90%) of the studied children. from the improved cases, near and far angle of strabismus were insignificantly improved after 3 and 6 months of treatment but the office control and stereopsis were significantly improved after 3 and 6 months of treatment. |