Purchase this article with an account.
M. L. Bratton, M. E. Hoehn, N. C. Kerr; Residual Strabismus in Children Following Resolution of Cranial Nerve Palsies Affecting Ocular Motility. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1206.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Children with cranial nerve palsies (CNP) are at risk for residual strabismus after their motility deficits resolve. We sought to evaluate if this was true for CNP secondary to a CNS malignancy.
We identified 106 children with CN III, IV, and/or VI palsies who were treated for CNS malignancies. A retrospective chart review was conducted to determine the presence or absence of residual strabismus following resolution of motility deficits.
Forty-eight of 106 children resolved their motility deficits with treatment of their CNS malignancy. One child had a CN III palsy, 6 had CN IV palsies (one was bilateral), 40 patients had CN VI palsies (16 were bilateral), and one child had two different CNP in the same eye (CN IV and VI). Of the 48 children who resolved their motility deficits, 35 patients had residual strabismus (Group A). Only 13 resolved their strabismus (Group B). Average angle of strabismus before motility deficits resolved was 33.8 prism diopters (PD) in Group A and 20.6 PD in Group B (not a statistically significant difference). There was no significant difference between Group A and B with regards to age at diagnosis or length of follow-up.
Our findings indicate that the majority of children with resolved motility deficits from a CNP after treatment for CNS malignancy will be left with residual strabismus, regardless of age at diagnosis, angle of strabismus at presentation, or type of CNP. Children with CNP secondary to CNS malignancy need ophthalmic care after motility deficits resolve, as they are likely to have residual strabismus, which can put the child at risk for visual system problems related to loss of binocularity, including amblyopia.
This PDF is available to Subscribers Only