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My 6
month old son has a large alternating outward deviation of the eyes. We noted
this since he was born. What is the optimal time for surgery with this kind of
deviation? Is the outcome of surgery promising?
Infantile
or congenital exotropia is a rare type of exodeviation. Most parents notice the
constant deviation by the age of six months but the onset is usually earlier.
The condition is likely caused by an arrest in the normal development of the
ability of the eyes to converge early in life. The amount of deviation is
usually more than 40 prism diopters because of the tight lateral rectus
muscles. Rarely, the oblique muscles may also be overacting and contractured,
producing a vertical component to the deviation, making the pattern of deviation
more complex. Oblique overactions usually present after one year of age and is
more commonly seen in infantile esodeviation.
The
approach to treatment starts with the management of amblyopia or “lazy eyes”, if
present, either through occlusion therapy or patching of the dominant eye, or
rarely, through the correction of any significant refractive error. Amblyopia
is present in 25% of cases due to the misalignment rather than any inequality in
refractive error.
As in any
kind of deviation, surgery should align the eyes by 2 years of age, in order to
achieve optimal motor and sensory outcome. Thinking that early surgery may be
beneficial, some surgeons consider doing surgery after 6 months of age.
Children with this condition have poor fusion potential, developing peripheral
fusion in only 50% of the time, with some gross stereopsis.
The goal
of surgery is to achieve a small amount of esotropia immediately after the
surgery because there is a natural tendency for the eyes to drift outwards. The
success for surgery is not very high. Undercorrections are common because the
surgical tables used as guide in determining the amount of muscle surgery does
not consider the presence of tight or contractured muscles, such as found in
infantile XT. Therefore a second surgery is sometimes necessary to correct any
residual deviation or any overaction of the oblique muscles.
There are several ways of reaching the ophthalmologists of EYE REPUBLIC Ophthalmology Clinic:
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ONLINE ACCESS
WEBSITES.
http://www.EyeRepublic.com.ph - EYE REPUBLIC
Ophthalmology Clinic
http://www.OCP.com.ph - Ophthalmic
Consultants Philippines Co. -
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Surgery Resource
http://www.Cataract.com.ph - Cataract Surgery Resource
http://www.Eye.com.ph - Eye
Information Online
http://www.EyeDoc4Kids.com.ph - Eye Information for Kids
http://www.Retina.com.ph - Retina
Surgery Resource
http://www.Glaucoma.com.ph - Glaucoma
Online
http://www.Uveitis.com.ph - Uveitis Online
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EYE REPUBLIC
Ophthalmology Atlas
CLINIC INFORMATION
Mobile E-Yellow Pages. Via
SMS, text LUK4 EYEREPUBLIC
(send to 2851 for Globe and Sun Cellular, and 2951 for Smart). |
EYE REPUBLIC Ophthalmology Clinic
Manila
3/F Don Santiago Building Units 309-310
1344 Taft Avenue, Ermita
Manila, 1000 Philippines
Direct and Fax: (632) 536-2398
Trunk Line: (632) 523-8271 to 79 local 30
Mobile: (63917) 899-2020
Map and directions
|
EYE REPUBLIC
Ophthalmology Clinic
Asian Hospital
and Medical Center
5/F Medical Office
Building (MOB) Suite 509
2205 Civic Drive,
Filinvest, Alabang
Muntinlupa City,
1781 Philippines
Direct:
(632) 771-9253
Direct and Fax:
(632) 771-9254
Mobile: (63917) 795-2020
Map and Directions
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EYE REPUBLIC Ophthalmology Clinic
Medical City
6/F Medical Arts Tower Inc (MATI) Suite 602
MERALCO Compound, Ortigas Avenue
Pasig City, 1604, Philippines
Direct and Fax: (632) 632-7846
Mobile: (63917) 537-2020
Map and directions
|
EYE REPUBLIC
Ophthalmology Clinic
St. Luke's
Medical Center
6/F
Cathedral Heights Building Complex (CHBC)
North Tower Suite 614
279 E. Rodriguez
Sr. Boulevard
Quezon City, 1102
Philippines
Direct and Fax:
(632) 407-3883
Mobile: (63917) 855-2020
Map and directions
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CLINIC HOURS
First-Come, First-Served
Monday to Saturday 9:00 AM to 6:00 PM
All clinics are closed on Sundays and Holidays
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CONGENITAL EXOTROPIA information
compiled by Dr.
Barbara L. Roque and initially uploaded on July 24, 2005.
Last updated on
September 20, 2007. |
