primary nonaccommodative esotropia
Introduction
Introduction to primary non-regulatory esotropia Congenital esotropia (congenitalesotropia) usually occurs within a few days after birth or within a few days after birth. Because the parents rarely see a baby during the neonatal period, congenital esotropia is rarely seen clinically. It is more common in early postnatal discovery. There is strabismus, because the parents of the child's eyes are less than one year old, often can not make accurate and objective judgments, it is possible to mistake the instability of the binocular visual axis as congenital internal oblique. In addition, during the baby period, because the nose is not yet fully developed, there are many internal suede and pseudo strabismus, which is also easy to cause confusion. Some acquired strabismus can also occur at this time, all of which can cause confusion in diagnosis. basic knowledge The proportion of illness: 0.005%--0.007% Susceptible people: children Mode of infection: non-infectious Complications: Amblyopia
Cause
Primary non-regulatory esotropia
The disease is a congenital disease with no obvious cause.
Prevention
Primary non-regulatory esotropia prevention
Early detection and timely and effective treatment of strabismus children are essential. Therefore, parents and teachers should pay attention to observe the abnormal signs of children. Children over the age of 3 should check their eyes regularly so that they can be discovered in time and treated early to avoid irreparable consequences. Experts suggest that in order to prevent children from strabismus and amblyopia, it is necessary to strengthen the child's eye health, use the eye reasonably and reasonably, and avoid overloading the eye.
Complication
Primary non-regulatory esotropia complications Complications amblyopia
Finally, the intermittent intervertebral vision develops into a constant esotropia, monocular gaze, amblyopia in strabismus, dioptic adjustment of esotropia, and other eye muscle abnormalities, such as vertical deviation and AV sign.
Symptom
Primary non-regulatory esotropia symptoms common symptoms rhomboid-phenotype nystagmus palsy
1. Most patients with congenital esotropia: the first eye has alternate fixation, the eyes have equal vision, and there are cross-gaze when looking at the sides, that is, when looking to the right, the left eye is watching, when looking to the left, right Eye gaze, a small number of patients without alternating gaze, amblyopia can occur amblyopia, the incidence of amblyopia is about 40%, and the degree of amblyopia is deep, accompanied by paracentral gaze.
(1) When looking to the right, the left eye is watching; (2) When looking to the left, the right eye is watching.
2, the oblique angle of view is large: generally greater than 30 , about 50% of patients exceed 50 , the distance between the distance and the angle of view is equal, and stable, unaffected by the adjustment, occasionally the angle of inclination has changed significantly within a few months, should pay attention to Children with eyes often cannot be abducted, but this is not the result of binocular abducens nerve paralysis, but secondary to cross-gaze. In another case, children with congenital esotropia have greater skewness and amblyopia. However, without cross-gaze, it is easy to mistake the paracentral gaze as one side of abductor nerve palsy. In fact, congenital unilateral or bilateral abducens nerve palsy is rare.
Congenital internal oblique should also be differentiated from eyeball regression syndrome, Mobius syndrome, and abducens nerve paralysis. The identification method is as follows: 1 Fix the child's head in an upright position, so that the child's head is slightly horizontally fast and slow. Rotate, give the road to stimulate, especially the horizontal semi-regular tube, a subtle abduction movement can occur in an instant, the hair can be closely observed, can be found; 2 will have a congenital internal oblique child with cross-gaze, including a few days, then The other eye can produce abduction exercise; 3 traction test, under general anesthesia, children with congenital internal oblique with cross-gaze, normal traction test, passive resistance during abduction, if the anesthesia is deepened, esotropia can disappear, and Appearing outside.
3, often combined with vertical strabismus: children with congenital esotropia to 2 to 3 years old, there may be dissociated vertigo deviation (DVD), manifested as non-gaze eye turn, external rotation, gaze down, Internal rotation; 78% of patients with excessive inferior oblique muscle function; also visible nystagmus, rotational or horizontal, tremor is sometimes recessive, appear only after covering one eye, or nystagmus during adduction Increased nystagmus during outreach.
4, ciliary muscle paralysis refractive examination proved mild, moderate hyperopia accounted for 90%, both eyes refractive similar, astigmatism or myopia may also exist.
5. AC/A is normal.
6, 1 measurement oblique angle, because infants and young children are not easy to do the prism cover test, commonly used Hirschberg and Krimsky method to measure, so that children look at the light, with the base outward prism to see how much degree can be used to reflect the corneal reflection in the center of the cornea is oblique Angle; 2 dilated optometry; 3 larger children do sensory tests.
The clinical features of congenital strabismus are large skew angle, stable oblique angle, and abnormal eye movement. Congenital esotropia can occur in normal children, but also in cerebral palsy and hydrocephalus. In children, the variation of the oblique angle increases with age, and the oblique angle can disappear. Occasionally, from June to 1 year, the esotropia can become external oblique.
Examine
Primary non-adjusting esotropia
Vision examination, fundus examination.
Diagnosis
Diagnosis of primary non-regulatory esotropia
diagnosis
Diagnosis can be performed based on clinical performance and laboratory tests.
Differential diagnosis
It is differentiated from primary common esotropia and common exotropia.
Congenital internal obliques should also be identified with eyeball regression syndrome, Mobius syndrome, and abducens nerve paralysis.
