title: The stability of the monofixation syndrome.
abstract: OBJECTIVE
  To determine etiology, characteristics, and stability of the monofixation syndrome (MFS) in a chart review of 63 consecutive patients in a private practice of pediatric ophthalmology.
  
  
  METHODS
  Retrospective, consecutive chart review.
  
  
  METHODS
  The charts of 63 consecutive patients with MFS, encountered from 2007-2012 followed for a minimum of 3 years were included. Best visual acuity, motor angle deviation at near, fusion, and stereoacuity as recorded on the most recent visit during the follow-up period were examined. Stability of the MFS was determined by comparing the dates of diagnosis with the last examination for those patients who remained stable. Decompensated patients were also studied for characteristics and results of secondary surgery.
  
  
  RESULTS
  The etiology of the MFS was esotropia in 58 (92.1%), anisometropia in 2 (3.2%), and exotropia in 3 patients (4.8%). The majority of patients, 57 of 63 (92%), had stable MFS for a mean of 13.9 years. Six esotropic patients decompensated after a mean of 6 years; 5 of these patients were restored to MFS by secondary surgery and 1 spontaneously recovered. Five patients were found to have improved stereoacuity to 60 arc seconds or better by the end of the study.
  
  
  CONCLUSIONS
  The MFS is a relatively stable binocular status during the first 2 decades of follow-up. A small percentage of patients decompensated, requiring secondary surgery to restore the MFS binocular status. A similar small percentage of MFS patients developed a higher grade of stereoacuity when followed for a sufficient interval of time.
authors.affiliation: University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii. Electronic address: malcolmingmd@hotmail.com.
authors.forename: Malcolm R
authors.initials: MR
authors.lastname: Ing
authors.affiliation: University of Hawaii, Honolulu, Hawaii.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Roberts
authors.affiliation: University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii.
authors.forename: Alexander
authors.initials: A
authors.lastname: Lin
authors.affiliation: University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii.
authors.forename: John J
authors.initials: JJ
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D015858:Anisometropia / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D002648:Child; D003867:Depth Perception / Q000502:physiology*; D004948:Esotropia / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D005099:Exotropia / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology*; D006801:Humans; D008297:Male; D010468:Perceptual Disorders / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult