RISK FACTORS FOR ESTROPIA

Conditions such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are emerging as risk factors for esotropia, the 3rd World Congress of Paediatric Ophthalmology and Strabismus (WCPOS) in Barcelona heard yesterday.

During yesterday’s WCPOS Strabismus Keynote Lecture, Lionel Kowal MD, Australia, said that these conditions, or the medications that patients take to treat them, are now becoming recognised as an esotropia risk factor. They sometimes cause labile accommodation and convergence with esotropia, but despite these issues there is “remarkably little data”, he told delegates.

“Probably 10 per cent of our paediatric populations in Western countries have these diagnoses, and no one has seriously looked at their eye problems and that is a real shame. It is a real defect in our knowledge,” Dr Kowal told ET Today.

Meanwhile, Dr Kowal cautioned delegates to be careful when adopting new strabismus technologies and procedures. He said while he had naturally changed his practices over the years; some things he had tried did not work. “Just because something is new, does not mean it is better,” he added.  

He noted that strabismus remains a very challenging condition, despite all the advances in ophthalmology, and the fact that it is the commonest paediatric eye condition.

“The stuff we do is very difficult to do, and it requires a lot of practice and many years to become an expert, and the more expert you become the more uneasy you become that you don’t know enough,” he summarised to ET Today.