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.
Biglan
A W
AW
Department of Ophthalmology, University of Pittsburgh School of Medicine, Pa, USA.
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