Surgery vs conservative management of strabismus

The prevalence of strabismus in infants with high-risk pre-threshold retinopathy of prematurity (ROP) varies significantly during the first year of life, leading to the conclusion that conservative management may be the best approach, according to the results of a trial published in the June issue of Archives of Ophthalmology.

Dr Deborah VanderVeen of the Boston Children's Eye Hospital and Harvard University, USA, led a team of researchers who examined 700 infants, at 26 sites, with high-risk pre-threshold or low-risk ROP for the presence of strabismus. At six months, the prevalence of strabismus was 20.3% in high-risk infants and 9.6% in low-risk infants.

For the high-risk infants, strabismus became more prevalent at nine months (30%) than it was at six months (20.3%). Risk factors at this age included abnormal fixation behaviour, the presence of amblyopia and having been born at centres outside of the study sites.

Dr VanderVeen advised managing the infants non-surgically, prescribing glasses, patching the opposite eye where amblyopia is present, and visual training.