J Korean Ophthalmol Soc > Volume 54(11); 2013 > Article
Journal of the Korean Ophthalmological Society 2013;54(11):1767-1771.
DOI: https://doi.org/10.3341/jkos.2013.54.11.1767    Published online November 15, 2013.
Acute-Onset Vertical Strabismus in Adults.
Yun Ha Lee, Ji Eob Kim, Sang Hoon Rah
Department of Ophthalmology, Wonju Severance Christion Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea. shrah@yonsei.ac.kr
성인에서의 급성 수직사시의 임상적 특징
이윤하⋅김지업⋅라상훈
Department of Ophthalmology, Wonju Severance Christion Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
Abstract
PURPOSE
To define the clinical characteristics of acute vertical strabismus in adults strabismus without known ocular and cranial external factors. METHODS: We performed a retrospective study of 72 adult patients who developed acute vertical strabismus without known ocular and cranial external factors such as trauma or operation and were followed up for at least 6 months. RESULTS: Undetermined cause (n = 41, 57%) was the most common etiology of acute vertical strabismus, followed by fourth cranial nerve palsy (n = 15, 20.8%), myasthenia gravis (n = 7, 9.7%), third cranial nerve palsy (n = 6, 8.3%), brain tumor (n = 2, 2.7%), and carotid-cavernous fistula (n = 1, 1.3%). The average vertical deviation at primary position was 7.2 prism diopter at initial visit. Thirty-eight (62.3%) patients recovered to orthophoria and 13 (21.3%) patients showed decreased level of diplopia. The average recovery period was 2.9 months. Ten cases remained as strabismus and 5 underwent surgery upon patient's request. CONCLUSIONS: Unknown cause was the most common diagonosis of adult acute vertical strabismus without known ocular and cranial external factors. In the present study, 62.3% of patients recovered to orthophoria and 83.6% recovered without surgical procedures.
Key Words: Acute diplopia;Vertical diplopia;Vertical strabismus


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