Strabismus (Squint)

Misalignment of the visual axes of the eyes. In comitant strabismus the degree of ocular misalignment does not vary with the direction of gaze. In noncomitant strabismus the degree of misalignment varies depending on direction of gaze or which eye is fixating on the target. (Miller, Walsh & Hoyt's Clinical Neuro-Ophthalmology, 4th ed, p641)

Also Known As:

Squint; Phoria; Hypertropia; Mechanical Strabismus; Convergent Comitant Strabismus; Comitant Strabismus; Comitant Strabismus, Convergent; Deviation, Dissociated Horizontal; Dissociated Horizontal Deviations; Dissociated Vertical Deviations; Heterophorias; Heterotropia; Horizontal Deviation, Dissociated; Hypertropias; Non Concomitant Strabismus; Noncomitant Strabismus; Strabismus, Concomitant; Strabismus, Convergent Comitant; Strabismus, Mechanical; Strabismus, Non-Concomitant; Strabismus, Nonconcomitant; Concomitant Strabismus; Dissociated Horizontal Deviation; Dissociated Vertical Deviation; Heterophoria; Heterotropias; Non-Concomitant Strabismus; Nonconcomitant Strabismus; Phorias; Strabismus, Comitant; Strabismus, Noncomitant

Networked: 3767 relevant articles (261 outcomes, 389 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Postoperative Nausea and Vomiting (PONV)
2.	Diplopia (Double Vision)
3.	Vomiting
4.	Amblyopia (Lazy Eye)
5.	Pain (Aches)

Experts

1.	Demer, Joseph L: 26 articles (12/2021 - 01/2003)
2.	Hunter, David G: 24 articles (01/2022 - 09/2005)
3.	Holmes, Jonathan M: 23 articles (10/2022 - 10/2002)
4.	Pineles, Stacy L: 20 articles (01/2022 - 02/2013)
5.	Hwang, Jeong-Min: 20 articles (03/2021 - 06/2006)
6.	Velez, Federico G: 18 articles (08/2019 - 04/2005)
7.	McLoon, Linda K: 15 articles (04/2021 - 02/2003)
8.	Arnold, Robert W: 15 articles (01/2021 - 01/2002)
9.	Lambert, Scott R: 13 articles (09/2022 - 12/2003)
10.	Christiansen, Stephen P: 13 articles (01/2022 - 03/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Strabismus:

1.	Botulinum Toxins (Botulinum Toxin)IBA 09/01/2017 - "Small retrospective studies have demonstrated the efficacy of botulinum toxin in the treatment of many types of pediatric strabismus, providing some guidance for clinicians to determine which patients would benefit most from this intervention. " 10/01/2003 - "Strabismus surgery in conjunction with intramuscular botulinum toxin injection can offer significant improvement in function and cosmesis of these patients." 03/01/2016 - "Botulinum toxin is a very useful tool in the management of strabismus, obtaining better sensory and motor results in children, but it is also effective as a symptomatic treatment in some types of strabismus in adults." 02/01/1997 - "Botulinum toxin was introduced as a safe and effective treatment for strabismus and other disorders of the extraocular muscles in the early 1980s. " 09/01/2004 - "The aim of this study is to determine the efficacy of a direct application of botulinum toxin in cases strabismus related to psychomotor retardation. "
2.	Ondansetron (Zofran)FDA LinkGeneric 03/01/2001 - "One hundred and thirty-one healthy children, aged 31-152 months, undergoing strabismus surgery under general anaesthesia, were randomly allocated to one of four groups: group A received 0.04 mg.kg-1 ( identical with 1 mg.m-2) of ondansetron, group B 0.1 mg.kg-1 ( identical with 2.5 mg.m-2), group C 0.2 mg.kg-1 ( identical with 5 mg.m-2) and group D placebo, given intravenously following induction of anaesthesia. " 04/01/2000 - "Surrogate, nonsurrogate, and therapeutic outcome measures revealed that 75 microg/kg ondansetron provided the same benefits as did 100 and 150 microg/kg. The routine prophylactic use of ondansetron at a dose of 75 microg/kg is as effective as 150 microg/kg in preventing PONV and improving the "true" outcome measures after strabismus repair in children." 09/01/2002 - "This study evaluated the clinical efficacy and cost-effectiveness of prophylactic ondansetron versus early ondansetron treatment in the management of postoperative nausea and vomiting (PONV) in children undergoing strabismus repair using clinically meaningful outcomes and value-based principles. " 04/01/2000 - "Prophylactic ondansetron in prevention of postoperative nausea and vomiting following pediatric strabismus surgery: a dose-response study." 02/01/2000 - "Effect of timing of ondansetron administration on incidence of postoperative vomiting in paediatric strabismus surgery."
3.	Metoclopramide (Reglan)FDA LinkGeneric 03/01/1998 - "Metoclopramide in a dose of 0.25 mg/kg administered intravenously prior to manipulation of eyeball is devoid of the effects but is not effective in preventing postoperative emesis in children undergoing strabismus surgery." 02/01/1990 - "Metoclopramide reduces the incidence of vomiting following strabismus surgery in children." 03/01/1998 - "To evaluate the efficacy of metoclopramide (0.25 mg/kg) administered IV immediately after induction of general anesthesia for the prevention of postoperative emesis in children undergoing, elective strabismus surgery. " 03/01/1998 - "Prophylactic metoclopramide administered immediately after the induction of anesthesia has no effect on the incidence of postoperative emesis after strabismus surgery." 02/01/1990 - "This randomized, double-blind study evaluated the efficacy of metoclopramide administered at the completion of surgery as an antiemetic agent in pediatric patients undergoing ambulatory strabismus surgery; 126 unpremedicated ASA Physical Status 1 and 2 children ranging in age from 2 to 18 yr served as subjects. "
4.	Dexamethasone (Maxidex)FDA LinkGeneric 06/01/2005 - "The purpose of the present study was to investigate the ocular hypertensive and anti-inflammatory responses to two different dosage schedules of 0.1% topical dexamethasone in a population of Chinese children undergoing strabismus surgery. " 01/01/2012 - "Dexamethasone reduces postoperative morbidity after adenotonsillectomy, strabismus surgery, and third molar extraction. " 11/01/2000 - "Topical dexamethasone (0.1%) was administered to children undergoing bilateral strabismus surgery. " 06/01/2005 - "The results suggest that dexamethasone 0.25 mg/kg is more effective than saline and equally effective compared with larger doses for preventing PONV for pediatric strabismus surgery." 06/01/2004 - "We conclude that dexamethasone 50 microg/kg is effective for the prevention of postoperative nausea and vomiting following strabismus repair in children."
5.	Droperidol FDA LinkGeneric 06/01/1990 - "Droperidol-induced extrapyramidal symptoms in an adolescent following strabismus surgery." 03/01/1981 - "Low doses (0.05 mg/kg) of intravenously administered droperidol were given intraoperatively to randomly assigned pediatric strabismus patients in a controlled double-masked paradigm. " 07/01/1991 - "To determine whether a low dose of droperidol is as effective as a high dose in preventing vomiting after pediatric strabismus surgery. " 07/01/1991 - "Droperidol 20 microgram/kg is as effective as droperidol 75 microgram/kg in preventing vomiting after pediatric strabismus surgery. " 10/01/1994 - "Droperidol can reduce the high incidence of vomiting after pediatric strabismus surgery; however, its use may be associated with sedation, delayed hospital discharge, dysphoria and extrapyramidal signs. "
6.	AntiemeticsIBA 11/01/1995 - "Randomized controlled studies were reviewed to assess the effectiveness and safety of antiemetics used for prophylaxis in paediatric strabismus surgery. " 09/01/2005 - "The incidence of POV ranges from 34 to 90% in children undergoing strabismus surgery when antiemetics are not administered prophylactically. " 09/01/1998 - "Prophylactic administration of an antiemetic is a common procedure for patients undergoing strabismus surgery. " 03/01/1998 - "However, there is no antiemetic effect in children undergoing strabismus surgery. " 08/01/1997 - "To compare the antiemetic efficacy and costs associated with two anaesthetic regimens in children undergoing strabismus surgery. "
7.	Granisetron (Kytril)FDA LinkGeneric 01/01/1999 - "Oral granisetron for strabismus surgery in children." 09/01/1999 - "Preoperative oral granisetron, in doses more than 40 microg/kg, is effective for preventing vomiting after strabismus surgery in children." 09/01/1999 - "To evaluate the efficacy of oral granisetron for the prevention of postoperative vomiting in children undergoing strabismus surgery. " 01/01/1999 - "To determine the efficacy of oral granisetron in preventing postoperative vomiting (POV) following strabismus repair in children. " 09/01/1999 - "Preoperative oral granisetron for the prevention of vomiting after strabismus surgery in children."
8.	Type A Botulinum Toxins (Botox)FDA Link 01/01/2008 - "Botulinum toxin A injection appears to be a safe and effective treatment for overcorrected and undercorrected strabismus after unsatisfactory surgery. " 03/24/2023 - "To assess the efficacy of botulinum toxin A injection in the treatment of strabismus in patients with neurological impairment and evaluate the factors associated with treatment success. " 03/01/2016 - "To analyse the indications, dosage and efficacy of botulinum toxin A injection performed in patients in a Strabismus Department. " 10/01/2023 - "Long-Term Effects of Botulinum Toxin A for Horizontal Concomitant Strabismus in Chinese Children." 07/01/2023 - "This need for more effective and less invasive treatment, along with the convergence of other events such as the development of electromyography, purification of botulinum toxin A, and the finding that injection of botulinum toxin type A could paralyze the hind limbs of chicks, led Dr. Alan Scott to investigate injection of his formulation for strabismus. "
9.	Mitomycin (Mitomycin-C)FDA LinkGeneric 10/01/2005 - "The intraoperative application of mitomycin C is a safe and effective adjunct to surgery in the treatment of restrictive strabismus." 05/01/2001 - "Intraoperative application of mitomycin C (0.2 mg/mL for 5 minutes) is a safe and effective adjunct to surgery in the treatment of restrictive strabismus." 10/01/2005 - "The aim of this study was to evaluate the efficacy of mitomycin C in reducing postoperative adhesions following strabismus surgery. " 05/01/2001 - "To evaluate the efficacy of mitomycin C in reducing reformation of adhesions following surgery for restrictive strabismus. " 06/01/1995 - "We evaluated the efficacy of mitomycin C in reducing the severity of postoperative adhesions following strabismus surgery and in delaying the time adjustment after surgery. "
10.	Propofol (Diprivan)FDA LinkGeneric 09/01/2007 - "To evaluate the safety and efficacy of propofol sedation combined with sub-Tenon's anaesthesia for strabismus surgery in adults. " 09/01/2018 - "Regarding primary endpoints, the use of propofol during strabismus surgery significantly increased the relative risk (RR) of oculocardiac reflex (RR 4.96, 95% confidence interval [CI]: 3.13-7.87, p < 0.00001; two studies, 257 children). " 10/01/1990 - "The purpose of this study is an investigation of two protocols using propofol as induction and maintenance agent in 100 children scheduled for strabismus surgery (4-8 year, ASA I, NYHA I). " 12/01/2021 - "Comparison of the ED50 propofol requirements during the insertion of laryngeal mask airway Ambu AuraFlex with Ambu AuraOnce in children undergoing strabismus surgery." 11/15/1992 - "Propofol and surgical contamination in strabismus surgery."

Therapies and Procedures

1.	Sutures (Suture) 02/01/2012 - "Adjustable sutures were most beneficial for patients undergoing reoperations for childhood strabismus." 02/01/2012 - "Adjustable suture use was particularly beneficial for patients undergoing a reoperation for childhood strabismus (success rate: nonadjustable, 42.4%; adjustable, 65.7%; P=0.0268; n = 100). " 01/01/2009 - "Single-stage adjustable suture strabismus surgery produces good results and is well suited to day case surgery." 11/01/1992 - "Strabismus surgery using one stage adjustable sutures was carried out under local anaesthesia in six patients with good results. " 09/01/2005 - "Full tendon transposition that is augmented with a posterior intermuscular suture is an effective procedure that results in improved ocular alignment in patients with paralytic strabismus and has a favorable complication profile."
2.	Telescopes 04/01/2018 - "Even if the strabismus has been longstanding, most adults will experience some improvement in binocular function after strabismus surgery. " 03/01/2015 - "Binocular summation scores improved postoperatively in most patients undergoing strabismus surgery. " 05/01/2014 - "Even if the strabismus has been long-standing, most adults will experience some improvement in binocular function after strabismus surgery. " 01/01/2020 - "Improvement in binocular visual acuity (VA) and visual field (VF) achieved after strabismus surgery could have beneficial effects on driving. " 05/01/2011 - "There was a significant reduction in the strabismus angle for distance and near, increase in abduction of the affected eye, and broadening of the field of binocular single vision. "
3.	Therapeutics 01/01/1986 - "Occlusion therapy administered to strabismus patients in the manner described in this study resulted in significant visual improvement with a regression in visual acuity of no more than an average of one line on the Snellen chart." 01/01/2016 - "The following outcomes were observed when comparing the results after vergence therapy to the baseline measurements: (a) near point of convergence and near dissociated phoria did not significantly change (p > 0.15); (b) latency, time to peak velocity, and settling time significantly decreased (p ≤ 0.01); and (c) accuracy significantly improved (p < 0.01). " 03/01/1986 - "Of these strabismic patients, 42 responded to therapy in which tropias were converted to phorias or the frequency of the manifest deviation was significantly reduced, fusional amplitudes were significantly enlarged, and in many cases, stereoacuity improved as well. " 09/01/1999 - "In total, 11 patients (79%) gained improved stereopsis and maintained satisfactory ocular alignment with toxin therapy and did not require squint surgery. " 01/01/2006 - "Topics for discussion will include the prevalence and type of strabismus, the effect of CP on eye movement systems, the efficacy of vision therapy for eye movement deficits, and strabismus surgery. "
4.	Anesthesia 10/01/2005 - "Improved timing of adjustment, improved anesthesia, and newer surgical techniques allow strabismus surgeons to offer treatment options better suited to the needs of each strabismus patient." 05/01/2018 - "Performing ptosis and strabismus surgery together appears to be clinically effective and safe, and reduces anesthesia exposure during childhood." 11/01/2021 - "Peribulbar anesthesia was an effective and safe option during strabismus surgery in adult patients." 05/01/2015 - "Contact topical anesthesia is a safe and effective alternative for strabismus surgery in adult patients. " 06/15/1990 - "Our results suggest that the use of peribulbar anesthesia is a safe and effective means of anesthesia in strabismus surgery because of minimal associated morbidity."
5.	Decompression 01/01/2001 - "In the selected subgroup of subjects with GO who required intervention, orbital decompression and strabismus surgery resulted in a significant reduction in IOP in the early postoperative period, especially in subjects with preoperative IOP greater than 21 mmHg." 04/01/2017 - "In this study, we aim to identify preoperative demographic and TED patterns associated with geriatric patients who underwent decompression surgery, to examine the effect of age on postoperative strabismus rates, and to identify factors that may contribute to postoperative strabismus in the geriatric subgroup. " 11/01/2011 - "The mean reduction in exopthalmos was 4.3 mm. An adverse effect of decompression on the postoperative squint angle was not evident in this study. " 07/01/2000 - "This study aimed to determine the relative incidence and time course of new-onset strabismus after balanced medial plus lateral wall orbital decompression versus decompression of the lateral wall alone for dysthyroid orbitopathy. " 12/01/1999 - "The data suggest that the appropriate sequence of treatment should first be suboccipital decompression, then strabismus surgery if spontaneous realignment does not occur, but further studies are needed to confirm this impression."