Sensory exotropia versus sensory esotropia: A comparative clinical features study

Mohammad Reza Akbari; Alaa Alghurab; Masoud Khorrami-Nejad; Elham Azizi; Babak Masoomian

doi:10.1016/j.optom.2024.100516

Sensory exotropia versus sensory esotropia: A comparative clinical features study

J Optom. 2024 Apr 24;17(3):100516. doi: 10.1016/j.optom.2024.100516. Online ahead of print.

Authors

Mohammad Reza Akbari¹, Alaa Alghurab², Masoud Khorrami-Nejad³, Elham Azizi⁴, Babak Masoomian¹

Affiliations

¹ Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
² Optometry Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
³ Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; Optometry Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: dr.khorraminejad@gmail.com.
⁴ Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Purpose: This study aimed to compare the preoperative clinical features of patients with sensory esotropia (ET) and sensory exotropia (XT).

Methods: In a retrospective study, the medical records of 13,252 patients who underwent strabismus surgery were reviewed at the Farabi Eye Hospital, Iran, from 2012 to March 2022. There were 1017 patients with sensory horizontal strabismus whose, in their worse eye, had corrected distance visual acuity (CDVA) equal to or <20/160 tested with the Snellen chart.

Results: The mean age of patients was 29.0 ± 12.4 years [574 (56.4%) males and 443 (43.6%) females]. Sensory XT and ET were observed in 717 (70.5%) and 300 (29.5%) patients, respectively (P<.001). The mean CDVA in the strabismic and non-strabismic eyes was 1.40 ± 0.75 and 0.05 ± 0.13, respectively (P<.001). Also, the CDVA in the strabismic eyes was significantly worse in the patients with sensory XT than in the patients with sensory ET (P<.001). Sphere and spherical equivalent (SE) components were more hyperopic in both eyes of patients with sensory ET than sensory XT (P<.001). In sensory ET group, the mean horizontal deviation at far and near was significantly higher than the sensory XT group (both P<.001). The prevalence of moderate and severe amblyopia among all patients with sensory strabismus was 274 (26.9%) and 727 (71.5%), respectively (P<.001). There were 398 (39.1%) patients who needed more than one surgery.

Conclusion: The frequency of sensory XT was about 2.5 times more than the sensory ET. Most patients with sensory ET were operated at a younger age, had better CDVA, more hyperopic spherical and SE, and higher angle of deviation compared with patients with sensory XT. The chance of reoperation in patients with sensory strabismus was about 40%.

Keywords: Amblyopia; Refractive error; Sensory esotropia; Sensory exotropia.