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Purpose: To investigate the changes in refractive status of amblyopic patients with partially refractive esotropia (PAET)., Materials and Methods: Amblyopic patients with PAET were enrolled. Non-amblyopic patients with full refractive accommodative esotropia (RAET) were included in the study as a control group. Preoperative and postoperative best-corrected visual acuity (BCVA), spherical equivalent (SE), astigmatism, stereoacuity, and deviations at near and distance were evaluated and statistically compared within the study group. Mean BCVA, SE, astigmatism were compared between the two groups., Results: The patient and the control groups were composed of 58 eyes of 29 patients per group. There were statistically significant differences between pre- and postoperative mean astigmatism and SE between the patient and control groups. The mean astigmatism was higher in amblyopic eyes when compared with the eyes in the control group (P:0.009). During the follow-up period, changes in SE and astigmatism were not different between groups., Conclusion: The mean SE and astigmatism were changed in both amblyopic patients with PAET and non-amblyopic patients with RAET during the follow-up period. This suggested that neither amblyopia nor strabismus surgery has an effect on refractive status in patients with PAET., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Introduction: In an environment where strabismus is poorly understood and management centers rare, we studied the epidemiological, clinical and therapeutic aspects of neglected childhood strabismus., Materials and Methods: This was a retrospective study carried out from March 1st, 2013 to September 30, 2018. Neglected childhood strabismus was defined as strabismus occurring in the first 5 years of life, for which the patient was over 7-years-old at the time of first consultation. The variables studied were age at first consultation, gender, age of onset, type of strabismus, etiology of strabismus, angle of deviation and rate of surgery., Results: We found 113 cases of neglected childhood strabismus among the 430 cases of strabismus seen during the study period. There were more females (n=64) than males. The mean age was 17.7±10.5 years. There were 73 exotropias (64.6 %). The mean angle of deviation was 41.2±12.2PD. Strabismus was early in 70.8 % of cases. Innervational strabismus accounted for 86.7 % of cases. The most frequent refractive error was hyperopic astigmatism (55.3 %). Of the 45 patients who were seen again after full-time wear of their full cycloplegic correction, 2 were orthotropic. Surgery was performed in 60.5 % of cases. The average postoperative angle of deviation was 6.6±9.4PD., Conclusion: Management of neglected childhood strabismus provides good results and should therefore be encouraged in order to improve the quality of life of affected patients., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Purpose: The management of A or V pattern deviation associated with esotropia can be challenging since the horizontal deviation changes with position of gaze. This study aimed to assess the effect of unilateral horizontal rectus surgery for the correction of horizontal deviation associated with A or V pattern in children with non-comitant infantile esotropia., Methods: Twenty-seven children with infantile esotropia and A-V pattern, more than 10 and 15 prism diopters respectively, were included in this retrospective observational single-center study. Horizontal rectus surgery was performed on the most deviated eye under general anesthesia. The patients were divided into two groups: A pattern and V pattern. The outcome measures were change in the amount of pattern and rate of regression after surgery. The amount of pattern was characterized by the difference in esodeviation between upgaze and downgaze., Results: Horizontal deviation at distance and near fixation decreased significantly (P<0.0001). Vertical gaze esotropia disparity decreased significantly (P=0.01 and P=0.0002 for A and V patterns respectively). A pattern esotropia was reported in only 2 (7%) cases after surgery compared to 9 (33%) before surgery. The number of subjects with V pattern esotropia decreased from 18 (67%) to 3 (11%) after surgery., Conclusions: The mechanisms involved in the pathophysiology of A and V patterns may not always be related to oblique muscle dysfunction. These findings suggest that unilateral horizontal rectus surgery may be an effective procedure to correct both horizontal deviation and A-V pattern in non-comitant infantile esotropia., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Purpose: To evaluate the interobserver reproducibility of objective ocular torsion measurements in infantile esotropia using fundus photography analysis., Materials and Methods: This retrospective observational study was conducted in our ophthalmology department at the University Hospital in Tours from 2009 to 2015., Objective: Ocular torsion was assessed using fundus photography and analysed on Adobe Photoshop software within a population of children with infantile esotropia. Two observers, an orthoptist and an ophthalmologist, carried out the evaluation separately. The interobserver agreement was calculated for quantitative measurement by the interclass correlation coefficient (ICC) and by Cohen's Kappa coefficient for qualitative assessment., Results: A total of 200 eyes (100 subjects, mean age: 6.88 years) were assessed. Statistical analyses for quantitative measurements resulted in an ICC of 0.98 (95% CI, 0.97-0.99) for right eyes, 0.96 (95% CI, 0.95-0.97) for left eyes, 0.98 (CI 95%, 0.97-0.98) for pre- operative eyes and 0.96 (95% CI, 0.95-0.97) for postoperative eyes. The ICC calculated on all four hundred fundus photographs was 0.97 (95% CI, 0.97-0.98). The interobserver agreement for qualitative measurements resulted in a Kappa coefficient of 0.91 for right eyes, 0.85 for left eyes, 0.90 for preoperative eyes and 0.86 for postoperative eyes. The analysis of all four hundred eyes returned a Kappa coefficient of 0.88., Conclusions: Objective ocular torsion assessment using our procedure, whether by an orthoptist or ophthalmologist, is a reliable and reproducible method for the management of infantile esotropia., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Purpose: We undertook a study on strabismus in order to determine the characteristics of this disease in Cameroon., Material and Methods: A prospective study was carried out in the ophthalmological unit of the Douala General Hospital from November 1991 to October 1995. All patients were examined and followed regularly by the same team., Results: We found 137 strabismus, which represent 1.22% of all patients with 51 esotropias (37.2%) and 86 exotropias (62.8%). The mean age was 13.61 years at the first consultation. 82.4% of convergent strabismus appeared before the age of one year against 67.4% of divergent strabismus. Moreover, amblyopia was found in 68.6% and 59.3% of cases respectively., Conclusion: As compared to European series, this study shows notably the great frequency of divergent squint in black africans and the fact that spontaneous evolution of the latter can lead to amblyopia in a large number of cases.

It is well known that good early management of squint prevents the appearance of functional amblyopia and, when it exists, allows a cure in more than 90% of cases. The authors report a series of 1 552 esotropias. Statistical analysis reveals that the present epidemiologic state of functional amblyopia is dismal. 47% of cases have an amblyopia in spite of 64.6% of children being previously treated. The mean age is 7 years 6 months. The therapeutic results after a 6 months range still shows 38% of poorly applied treatment, but 57% of well-managed patients recover normal visual acuity. The long range results (average 33 months) show that in 47% of cases the treatment was badly applied. On the contrary, 70% of patients having good management were successful. Two main reasons explain such a situation : firstly the lack of information and casualness of parents; and on the other hand faltering and unsuitable medical technics. The only real answer to such a problem is early medical management of every squint. According to the author's experience it seems that such a state is not a special feature of amblyopia epidemiology in the western part of France, but it is observed in the same way in many countries having high level medical care.