Strabismus associated with meningomyelocele.
BACKGROUND
Strabismus occurs frequently in patients with spina bifida or meningomyelocele.


METHODS
I performed 1544 eye examinations in 298 patients with spina bifida over a period of 15 years. The patient records were retrospectively reviewed for visual acuity, binocular function, and strabismus. Select patients with A-pattern strabismus were recalled for neuroimaging.


RESULTS
Visual acuity was correctable to 20/40 in 85% of the patients. One hundred and eighty-three patients (61%) had strabismus at some time over the study period. Sixty-three percent had an esodeviation; 37% an exodeviation. A-pattern strabismus was more common in patients with exotropia (39%) than in those with esotropia (27%). Defects on neuroimaging in the region of the vertical gaze pathways in the brain stem were correlated with A-pattern strabismus.


CONCLUSIONS
With increased longevity of the patient with spina bifida, quality-of-life issues become increasingly important. Amblyopia, strabismus, and other acquired defects in the visual system related to hydrocephalus should be closely monitored and treated when indicated.
Department of Ophthalmology, University of Pittsburgh School of Medicine, Pa, USA.
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Biglan
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000209:etiology / Q000628:therapy; D007223:Infant; D008297:Male; D008591:Meningomyelocele / Q000150:complications*; D012189:Retrospective Studies; D016135:Spinal Dysraphism / Q000150:complications; D013285:Strabismus / Q000175:diagnosis / Q000209:etiology*; D014792:Visual Acuity