Postural control in children with strabismus: Effect of eye surgery

Legrand, Agathe; Quoc, E. Bui; Vacher, Sylvette Wiener; Ribot, Jérôme; Lebas, Nicolas; Milleret, Chantal; Bucci, Maria Pia

doi:10.1016/j.neulet.2011.06.056

Cited by 42 publications

(46 citation statements)

References 23 publications

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“…More recently, Legrand et al recorded the postural stability of nine children with strabismus before and after eye surgery. 9 Their results indicate that postural stability worsens immediately following surgery (2 weeks) and, indeed, this finding is in keeping with an earlier study conducted by Matsuo et al on children from 3 to 12 years of age. 10 Nevertheless, Legrand et al showed that posture improved as early as eight weeks postoperatively.…”

supporting

confidence: 85%

“…10 Nevertheless, Legrand et al showed that posture improved as early as eight weeks postoperatively. 9 As a secondary observation, the investigators reported the absence of a preoperative stabilizing effect of proximity following an hour of habituation with corrective prisms. Similarly, and regardless of whether or not corrective prisms were worn by the subjects, no postoperative stabilizing effect of proximity was observed for any of the conditions studied in combination with fixation at near and far distances.…”

Section: Discussionmentioning

confidence: 99%

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Postural Control in Nonamblyopic Children with Early-Onset Strabismus

Gaertner

Creux²,

Espinasse-Berrod³

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. In healthy subjects, the postural stability in orthostatic position is better when fixating at near than at far. Increase in the convergence angle contributes to this effect. Children with strabismus present a deficit in vergence. We evaluated postural control in children with respect to the vergence angle as they fixated at different depths, thereby engaging in active vergence movements. METHODS.A TechnoConcept platform was used to record the postural stability of 11 subjects (mean age 11.18 6 4.02 years) with convergent strabismus and 13 (mean age 11.31 6 3.54 years) with divergent strabismus in 3 conditions: fixation at 40 cm, at 2 m, and active vergence movements between 20 and 50 cm. RESULTS.The mediolateral body sway decreased significantly with proximity for convergent strabismus (from 3.78-2.70 mm) but increased significantly for divergent strabismus (from 3.27-3.97). Relative to fixation, vergence eye movements resulted in a statistically significant increase in mediolateral body sway for convergent strabismus (3.55 vs. 2.70) and a decrease for divergent strabismus (3.11 vs. 3.97, P ¼ 0.047). Vergence eye movements were associated with the least variance of speed (99 mm 2 /s 2 for convergent and 117 mm 2 / s 2 for divergent strabismus), so less energy was required to control body sway. CONCLUSIONS.The fixation depth at which postural stability is best is proximal for convergent strabismus and distal for divergent strabismus. Optimal postural stability might be mediated by preponderant eye movement signals related to the angle of strabismus. T o maintain the body in a stable position, the central nervous system uses multiple sensorimotor inputs that are at once visual, proprioceptive, vestibular, and somesthetic.Paulus et al. demonstrated that postural control improves while fixating at near rather than at far distances.1 They attributed what we henceforth will refer to as the stabilizing effect of proximity to the angular size of the retinal drift, such that at near distances the angular size of the retinal slip input resulting from body sway is higher than at far distances. The ensuing afferent signal feeds back into mechanisms of postural control potentially leading to an improvement in body stabilization.However, Kapoula and Lê showed that the stabilizing effect that results from the relative proximity of a fixation target also is due to oculomotor signals generated by the vergence angle itself. 2 Indeed, the efferent and afferent signals related to the vergence angle are stronger at near distances as a consequence of the relative increase in ocular convergence required to fixate a proximal target as opposed to a distal one. In their study, convergent prisms were used to make the eyes converge while the subjects were fixating at far distances. Despite the conflict with the physical distance, convergence of the eyes resulted in an improvement in postural stability. This stabilizing effect of proximity is present in children 3 and in the elderly. Bucci et al. showed that children with a vergen...

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confidence: 85%

Section: Discussionmentioning

confidence: 99%

Postural Control in Nonamblyopic Children with Early-Onset Strabismus

Gaertner

Creux²,

Espinasse-Berrod³

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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“…Note, however, that the effect of general anesthesia could be still present after 3 days. Recently, we reported that, about 8 weeks after strabismus surgery, children's postural stability had significantly improved, suggesting that the somatosensory properties of the extra-ocular muscles together with visual perception influenced body stability [9]. Such improvement was not due to restoration of binocular visual capabilities, because in children with early onset strabismus any binocular disparity capability was absent and eye surgery cannot restore binocular functions.…”

Section: Introductionmentioning

confidence: 99%

Re-alignment of the eyes, with prisms and with eye surgery, affects postural stability differently in children with strabismus

Legrand

Bui-Quoc

Bucci

2011

Graefes Arch Clin Exp Ophthalmol

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“…Vision appears to be the primary input in terms of relating to one's position in space in infancy (Legrand et al, 2011;Morningstar et al, 2005) and balance again becomes more visually dependent with age from the mid-forties onwards (Poulain & Giraudet, 2008). There is a suggestion that it may not just be sight that is important in terms of visual input to balance.…”

Section: Sensory Integrationmentioning

confidence: 99%

Can eyes cause neck pain?

Hood

2016

International Journal of Therapy and Rehabilitation

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This article is an analysis of literature relating to ocular-motor imbalance and the potential postural consequences. It aims to highlight the importance of sensory integration between the visual and vestibular systems and proprioception. The consequences of extra-ocular muscle imbalance are discussed in terms of the disruption to this sensory integration. The symptoms that this may give rise to include spinal pain, postural instability and potential increased risk of falls. This paper therefore encourages a wider multi-disciplinary awareness in managing patients with such symptoms.

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Postural control in children with strabismus: Effect of eye surgery

Cited by 42 publications

References 23 publications

Postural Control in Nonamblyopic Children with Early-Onset Strabismus

Postural Control in Nonamblyopic Children with Early-Onset Strabismus

Re-alignment of the eyes, with prisms and with eye surgery, affects postural stability differently in children with strabismus

Can eyes cause neck pain?

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