Author/Editor		Rudolf-Vukan, M
Title		Zgodnja diagnostika in operativna terapija kongenitalnega konvergentnega škiljenja
Translated title		Early diagnosis and operative treatment of congenital convergent paralytic strabismus
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 62, št. 12
Publication year		1993
Volume		str. 581-6
Language		slo
Abstract		Background. Congenital convergent paralytic strabismus is a disorder which may have grave consequences to visual development and aesthetic appearance of a patient, if not treated early. Early diagnosis and operative treatment, preferably in the first year of life, is therefore essential. Since 1985, we diagnosed congenital convergent paralytic strabismus in 20 children out of which, 14 (70 per cent ) were operated in their first year. Methods. Treatment consisted of correction of refractive errors, surgery and orthoptic-pleoptic training. Preoperatively, retinoscopy was performed at the age of six months onwards, glasses were prescribed, and occlusion treatment or atropinization was performed. If these measures were not sufficient to achieve central fixation, the child was operated. In 18 out of 20 operated children, retroposition of internal rectus muscles were performed alone or in combination with resection of external muscles in one or both eyes. In two cases, operation after the method of Hummelscheim was done. Operative treatment was followed by postoperative orthoptic-pleoptic training. Results. Trough operative treatment and orthoptic-pleoptic training the objective squint angle was diminished, and visual acuity and aesthetic apperance was improved. Four cases are presented in detail. In three of them, postoperative visual acuity of 1.0 was achieved, with good abduction and convergence, and favourable aesthetic appearance. In the fourth presented case, the child was operated at the age of four years and visual operation and intensive orthoptic-pleoptic training. acuity could not be markedly improved despite successful Conclusions. Congenital paralityc strabismus requires surgery in the child's first year or at the latest by the age of 18 months. This is the essential prerequisite by which adverse consequences, such as grave amblyopia, contraction of the eye muscles and ocular torticollis, may be avoided.
Descriptors		ESOTROPIA CHILD ORTHOPTICS ATROPINE