eMedicine Specialties > Ophthalmology > Extraocular Muscles

Esotropia and Exotropia, V-patterns: Follow-up

Author: Neepa Thacker, MBBS, MS, DNB, FRCS, Consulting Staff, Department of Pediatric Ophthalmology and Strabismus, Breach Candy Hospital, Mumbai, India
Coauthor(s): Arthur L Rosenbaum, MD, Chief, Division of Pediatric Ophthalmology, Professor, Vice Chairman, Department of Ophthalmology, University of California at Los Angeles School of Medicine; Frederico G Velez, MD, Assistant Clinical Professor, Department of Ophthalmology, Division of Pediatric Ophthalmology and Strabismus, University of California at Los Angeles School of Medicine
Contributor Information and Disclosures

Updated: Sep 26, 2006

Follow-up

Further Inpatient Care

  • Surgery for the patient with strabismus usually is performed as an outpatient procedure.

Further Outpatient Care

  • Although regimens vary among surgeons, regular follow-up visits are necessary to determine if the eyes are well aligned and if fusional abilities are present and stable.

Complications

  • If left untreated, loss of fusion and stereopsis could occur. If the patient freely alternates, the chance of amblyopia is reduced.
  • Complications associated with surgery include undercorrection and overcorrection and/or residual or new oblique muscle dysfunction.
  • Postoperative complications include residual A- or V-pattern strabismus, diplopia, and undercorrection or overcorrection of the horizontal deviation.

Prognosis

  • The prognosis for patients with this condition is good. Only one surgery is required to correct the deviation in 80-85% of patients; 10-15% of patients may need a second or third procedure for good alignment.
  • Success for binocularity depends on the patient's age, the time of presentation, and any previous amblyopia.

Miscellaneous

Medicolegal Pitfalls

  • Failure to detect and appropriately treat this condition could result in loss of binocularity and possibly amblyopia.
 


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References
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References

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  2. Boyd TA, Leitch GT, Budd GE. A new treatment for ''A'' and ''V'' patterns in strabismus by slanting muscle insertions. A preliminary report. Can J Ophthalmol. Jul 1971;6(3):170-7. [Medline].

  3. Brown HW. Vertical deviations symposium: Strabismus. Trans Am Acad Ophthalmol Otolaryngol. 1953;57:157.

  4. Caldeira JA. Some clinical characteristics of V-pattern exotropia and surgical outcome after bilateral recession of the inferior oblique muscle: a retrospective study of 22 consecutive patients and a comparison with V-pattern esotropia. Binocul Vis Strabismus Q. 2004;19(3):139-50. [Medline].

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Further Reading

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Keywords

V-pattern strabismus, vertically incomitant horizontal deviations, A-pattern, V-pattern, horizontal deviation, upgaze, downgaze, angle of deviation, V-pattern esotropia, V-pattern exotropia

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Contributor Information and Disclosures

Author

Neepa Thacker, MBBS, MS, DNB, FRCS, Consulting Staff, Department of Pediatric Ophthalmology and Strabismus, Breach Candy Hospital, Mumbai, India
Disclosure: Nothing to disclose.

Coauthor(s)

Arthur L Rosenbaum, MD, Chief, Division of Pediatric Ophthalmology, Professor, Vice Chairman, Department of Ophthalmology, University of California at Los Angeles School of Medicine
Arthur L Rosenbaum, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and American Medical Association
Disclosure: Nothing to disclose.

Frederico G Velez, MD, Assistant Clinical Professor, Department of Ophthalmology, Division of Pediatric Ophthalmology and Strabismus, University of California at Los Angeles School of Medicine
Frederico G Velez, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

Michael J Bartiss, OD, MD, Medical Director, Ophthalmology, Family Eye Care of the Carolinas
Michael J Bartiss, OD, MD is a member of the following medical societies: American Academy of Ophthalmology, American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus, and North Carolina Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

J James Rowsey, MD, Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida
J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Ralph Garzia, OD, Assistant Dean for Clinical Programs, Associate Professor, School of Optometry, University of Missouri at St Louis
Ralph Garzia, OD is a member of the following medical societies: American Academy of Optometry and American Optometric Association
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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