Cerebral Palsy for the Pediatric Eye Care Team—Part II: Diagnosis and Treatment of Ocular Motor Deficits

Abstract

Infantile strabismus is significantly more common in children with CP than in the general pediatric population. Disorders of eye movements are also very common. Based on our experience and review of the literature there is no convincing evidence that vision therapy significantly improves eye movements or visual functioning. Approximately 2 of every 3 cases of nonaccommodative strabismus associated with CP can be successfully managed with conventional strabismus surgery, though most children will require at least two surgeries to achieve alignment.

Evaluation of postoperative discomfort after strabismus surgery under general anesthesia in children: a prospective observational study

“…In contrast, Huang et al reported that 28.57% of adult patients felt dizziness. Previous studies explained that dizziness may be due to the residual effect of anesthetics, inadequate hydration, and surgical outcome [18,35]. The results of the multivariate analysis in this study showed that age and history of motion sickness were signi cantly associated with dizziness.…”

Surgical responses and outcomes of bilateral lateral rectus recession in exotropia with cerebral palsy

“…Spastic CP was by far the most common type, which was not different from overall patients with CP (Hiles ; Jackson et al. ). Further studies with modified surgical protocols and different types of surgery, including recess and resect procedures, may be required to provide appropriate guidelines for the management of exotropia in patients with CP.…”

“…Strabismus is one of the most common ocular morbidities associated with cerebral palsy (CP), with rates exceeding those detected in the general population (Pigassou-Albouy & Fleming 1975;Scheiman 1984;Katoch et al 2007;Woo et al 2011). However, more conservative approaches to the surgical management of strabismus have been applied to patients with CP compared to the general population due to higher rate of overcorrection, instability of angle measurements, poor co-operation for examinations, less expectation of functional improvement after strabismus surgery and poor medical conditions (Hiles 1975;Jackson et al 2006). Our recent report of the surgical outcome of medial rectus (MR) recession in esotropes with CP showed a larger surgical response and a higher incidence of late overcorrection compared to esotropes without CP and suggested that the reduction of the amount of MR recession may be necessary in esotropes with CP (Ma et al 2013).…”

<p>Risk Factors Associated with Postoperative Discomfort After Ambulatory Strabismus Surgery Under General Anesthesia</p>

“…20 Moreover, surgical outcome, for example, change of eye position postoperatively might be attributed to the dizziness symptom, and visual recovery training after the surgery could help to relieve dizziness. 21 Based on the multivariate analysis performed within this study, the independent predictor of postoperative dizziness was mild anxiety. Thus, a multimodal approach, which could include the identification of patients with anxiety, and optimizing perioperative management of these patients, such as minimizing anesthetics and adequate hydration, would be of greater significance.…”