Strabismus in pediatric lens disorders.

Purpose: To evaluate the prevalence and types of strabismus in children with cataract and ectopia lentis.

Methods: The authors retrospectively evaluated 860 children treated in the ophthalmological department of Children's Hospital "Agia Sophia" during the past decade. Their medical files with reference to strabismus prevalence, correlation between the time of strabismus occurrence and lens extraction surgery, and type of strabismus were studied.

Results: Of the 822 children with cataract, 337 had congenital cataract and 485 had acquired cataract. Strabismus occurred in 199 (24.2%) patients; 113 (56.8%) patients had esotropia and 86 (43.2%) patients had exotropia. Of the 38 children with ectopia lentis, strabismus occurred in 5 (13.2%); 1 patient had esotropia and 4 patients had exotropia. There is no significant difference in the time of appearance of strabismus in relation to the cataract operation, whereas there is a significant difference in ectopia lentis, although this may be a result of the small sample size. The incidence of strabismus is higher in patients with unilateral cataracts (27.4%) than in those with bilateral cataracts (19.6%). Strabismus occurred more frequently in patients with congenital cataracts (30.3%) than in acquired cases (20%), with esotropia being more common in congenital cataracts (76.5%) and exotropia more common in acquired cataracts (63.9%).

Conclusion: The authors believe it is imperative that great attention should be given to ocular alignment in addition to management of refractive error and intense amblyopia therapy during long-term follow-up.