Diagnosis Strabismus

Oleh :

dr. Felicia

Diagnosis strabismus dapat diklasifikasikan menjadi deviasi manifes atau –tropia dan laten atau –phoria. Strabismus manifes memberikan gambaran klinis yang jelas pada saat kedua mata dibuka dan akan bergerak secara involunter setelah mata yang sehat ditutup atau cover test. Sementara itu, pada strabismus laten, gambaran klinis tidak selalu terlihat, tetapi dapat terinduksi dengan melakukan alternate cover test.[13]

Eksotropia dan esotropia dapat terjadi secara intermiten. Istilah intermiten ini didapatkan pada keadaan dimana sebenarnya pasien dapat mempertahankan posisi bola mata tanpa deviasi, tetapi pada keadaan tertentu, seperti stress atau sakit, deviasi bola mata dapat terlihat.

Pada anamnesis dan pemeriksaan fisik strabismus, perlu diperhatikan tanda bahaya, yaitu:

Red reflex yang abnormal

Keterbatasan gerakan abduksi

Diplopia

Nyeri kepala

Nystagmus

Kecenderungan kepala menoleh pada sisi tertentu

Gangguan neurologis, seperti cerebral palsy[1]

Referensi

1. Sawers N, Jewsbury H, Ali N. Diagnosis and management of childhood squints: investigation and examination with reference to red flags and referral letters. Br J Gen Pract. 2017 Jan 1;67(654):42–3.
3. Minichello MA. Adult Strabismus and Vision Therapy. Electronic Thesis or Dissertation. Ohio State University, 2015;78. https://etd.ohiolink.edu/pg_10?0::NO:10:P10_ACCESSION_NUM:osu1429747867
6. Chopra V, Balasubramanian P. Clinical Study Of Concomitant Squint. J Evid Based Med Healthc. 2017 Jul 5;4:3294–7.
13. O’Dowd C. RACGP - Evaluating squints in children. AFP. 2013 Dec;42(12):872–4.
15. Zhangqing F, Junhong L. An interpretation of Adult Strabismus Preferred Practice Pattern. Chin J Exp Ophthalmol. 2020 Jun 10;38(06):527–32.
24. Dagi LR, Velez FG, Archer SM, et al. Adult Strabismus Preferred Practice Pattern. Ophthalmology. 2020 Jan;127(1):P182–298.
27. Xu TT, Bothun CE, Hendricks TM, et al. Pseudostrabismus in the First Year of Life and the Subsequent Diagnosis of Strabismus. Am J Ophthalmol. 2020 Oct;218:242–6.
44. Yehezkel O, Belkin M, Wygnanski-Jaffe T. Automated Diagnosis and Measurement of Strabismus in Children. Am J Ophthalmol. 2020 May;213:226–34.
45. Holmes JM, Liebermann L, Hatt SR, et al. Quantifying diplopia with a questionnaire. Ophthalmology. 2013 Jul;120(7):1492–6.
46. Teodorescu L. Anomalous Head Postures in Strabismus and Nystagmus - Diagnosis and Management -. Romanian J Ophthalmol. 2015;59(3):137–40.
47. Aoba K, Matsuo T, Hamasaki I, Hasebe K. Clinical factors underlying a single surgery or repetitive surgeries to treat superior oblique muscle palsy. Springerplus. 2015;4:166. Published 2015 Apr 7. doi:10.1186/s40064-015-0945-3
48. Reddy AC, Portilla A, Donahue SP. Purely horizontal strabismus associated with head tilt. J Am Assoc Pediatr Ophthalmol Strabismus. 2018 Feb;22(1):69–71.
49. Murray C, Newsham D. Normative Values for the Accommodative Convergence to Accommodation Ratio (AC/A). Invest Ophthalmol Vis Sci. 2010 Apr 17;51(13):801–801.
50. Craig Murray MRes BsH, David Newsham PhD D MSc. The Normal Accommodative Convergence/Accommodation (AC/A) Ratio. J Binocul Vis Ocul Motil. 2018 Oct 2;68(4):140–7.
51. Dericioğlu V, Çerman E. Quantitative measurement of horizontal strabismus with digital photography. J Am Assoc Pediatr Ophthalmol Strabismus JAAPOS. 2019 Feb 1;23(1):18.e1-18.e6.
52. Cifuentes DL, Pineles SL, Demer JL, et al. Surgical success and lateral incomitance following three-muscle surgery for large-angle horizontal strabismus. J Am Assoc Pediatr Ophthalmol Strabismus. 2018 Feb;22(1):17–21.
53. Sreedhar A, Menon A. Understanding and evaluating diplopia. Kerala J Ophthalmol. 2019 Aug 27;31(2):102–11.
54. Sathyan S, Beena N, Nair D, et al. Convergence insufficiency. Kerala J Ophthalmol. 2016;28(2):88.
55. Pihlblad MS. When to Image a Patient With Strabismus. American Academy of Ophthalmology. 2017. https://www.aao.org/young-ophthalmologists/yo-info/article/when-to-image-a-patient-with-strabismus
56. Clark RA. Orbital Imaging in Strabismus. J Binocul Vis Ocul Motil. 2018 Jul 3;68(3):87–98.
57. Dudea SM. Ultrasonography of the eye and orbit. Med Ultrason. 2011 Jun;13(2):171–4.
58. Rossetto JD, Cavuoto KM, Allemann N, et al. Accuracy of Optical Coherence Tomography Measurements of Rectus Muscle Insertions in Adult Patients Undergoing Strabismus Surgery. Am J Ophthalmol. 2017 Apr;176:236–43.
59. Chopra R, Mulholland PJ, Tailor VK, et al. Use of a Binocular Optical Coherence Tomography System to Evaluate Strabismus in Primary Position. JAMA Ophthalmol. 2018 Jul 1;136(7):811.
60. American Academy of Ophthalmology (AAO). 6. Pediatric Ophthalmology and Strabismus. BCSC Basic and Clinical Science Course 2022–2023. AAO, 2022–2023.
61. Peterseim MMW, Davidson JD, Trivedi R, et al. Detection of strabismus by the Spot Vision Screener. J Am Assoc Pediatr Ophthalmol Strabismus. 2015 Dec;19(6):512–4.
62. Kassem AM. Automated Vision Screening. Adv Ophthalmol Optom. 2018 Aug 1;3(1):87–100.
70. House RJ, Rotruck JC, Enyedi LB, et al. Postoperative infection following strabismus surgery: case series and increased incidence in a single referral center. J Am Assoc Pediatr Ophthalmol Strabismus. 2019 Feb;23(1):26.e1-26.e7.

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Masuk atau Daftar

Nomor Ponsel Sudah Terdaftar

Masuk dengan Email

Masuk dengan Email

Masuk dengan Facebook

Diagnosis Strabismus

Referensi

Masuk atau Daftar

Artikel Terkait