Download PDF
Kinder- und Jugendmedizin 2014; 14(03): 157-164
DOI: 10.1055/s-0038-1629390
Augenheilkunde
Schattauer GmbH

Akuter Strabismus im Kindesalter

Acute-onset strabismus in children
I. Sterker
1   Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Leipzig AöR
› Author Affiliations
Further Information

Publication History

Eingereicht am:25 November 2013

angenommen am:04 December 2013

Publication Date:
31 January 2018 (online)

    Permissions and Reprints

Zusammenfassung

Akut einsetzendes Schielen bei Kindern ist für Eltern durch die auffällige Augenstellung eine beunruhigende Situation, die sie veranlasst, umgehend einen Kinder- oder Augenarzt aufzusuchen.

Da akutes Schielen Symptom einer bedrohli-chen Erkrankung sein kann, muss eine Diagnostik unverzüglich erfolgen.

Die strabologisch-neuroophthalmologische Untersuchung mit einer okulären Motilitätsanalyse, Refraktionsbestimmung und Papillenbeurteilung kann klären, ob eine harmlose dekompensierende oder kongenitale Schiel-form zugrunde liegt, oder ob eine neuropädiatrische Abklärung des Schielens erforderlich ist.

Die Differenzialdiagnosen sowohl häufiger als auch seltener Erkrankungen werden an-hand klinischer Zeichen, spezieller Diagnostik und deren Therapiemöglichkeiten detailliert dargestellt.

Summary

Acute-onset strabismus in children, with its conspicuous appearance, is always disconcerting for parents and leads them to seek prompt medical attention from a paediatrician or ophthalmologist.

Since life-threatening conditions can cause acute strabismus, diagnostics must be performed immediately.

A strabologic-neuroophthalmologic examination, including motility testing, determination of refraction, and assessment of the optic disc, can clarify whether a harmless, de-compensation or congenital strabismus is present or whether a neuropaediatric evaluation is necessary.

The differential diagnosis, from common to rare disorders, as well as their clinical, special diagnostics, and therapeutic options are discussed in detail.

Schlüsselwörter

Akutes konkomittierendes nicht akkommodatives Innenschielen - kongenitale Schielformen - erworbenes Lähmungsschielen

Keywords

Acute-onset non-accommodative comitant esotropia - congenital strabismus - acquired paralytic strabismus
 

  • Literatur

  • 1 Alcala-Galiano A, Arribas-Garcia IJ, Martin-Perez MA. et al. Pediatric fractures: children are not just small adults. Radiographics 2008; 28: 441-461.
    CrossrefPubMedGoogle Scholar
  • 2 Andrews PI, Massey JM, Sanders DB. Acetylcholine receptor antibodies in juvenile myasthenia gravis. Neurology 1993; 43: 977-982.
    CrossrefPubMedGoogle Scholar
  • 3 Astle WF, Miller SJ. Acute comitant esotropia: A sign of intracranial disease. Can J Ophthalmol 1994; 29: 151-154.
    PubMedGoogle Scholar
  • 4 Bornfeld N, Gerasimos A, Fitzek M. et al. Perspektiven der Ophthalmoonkologie. Dtsch Ärztebl 2004; 101: A-2526/B-2130/C-2049
    Google Scholar
  • 5 Brown HW. Congenital structural anomalies. In Allen JH. (Hrsg). Strabismus ophthalmic symposium St. Louis: Mosby; 1950: 205-236.
    Google Scholar
  • 6 Bundey S. A genetic study of infantile and juvenile myasthenia gravis. J Neurol Neurosurg Psychiatry 1972; 35: 41-51.
    CrossrefPubMedGoogle Scholar
  • 7 Dotan G, Rosenfeld E, Stolovitch C, Kesler A. The role of neuroimagimg in the evaluation process of children with isolated sixth nerve palsy. Childs Nerv Syst 2013; 29: 89-92.
    CrossrefPubMedGoogle Scholar
  • 8 Ellis FJ, Jeffrey AR, Seidman DJ. et al. Possible association of congenital Brown syndrome with congenital cranial dysinnervation disorders. J AAPOS 2012; 16: 558-564.
    CrossrefPubMedGoogle Scholar
  • 9 Engle EC. The genetic basis of complex strabismus. Pediatric research 2006; 59: 343-348.
    CrossrefPubMedGoogle Scholar
  • 10 Esser J, Mühlendyck H. Myogene Augenbewegungsstörungen. In: Kaufmann H, Steffen H. (Hrsg). Strabismus Stuttgart, New York: Thieme; 2012: 453-457.
    Google Scholar
  • 11 Gräf M. Akuter Strabismus. Klin Monatsbl Augenheilkd 2004; 221: R71-R97.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Gerber B, Kiwanuka P, Dhariwal D. Orbital fractures in children: A review of outcomes. Br J Oral Maxillofac Surg 2013; 51: 789-793.
    CrossrefPubMedGoogle Scholar
  • 13 Gerbino G, Roccia F, Bianchi FA, Zavattero E. Surgical management of orbital trapdoor fracture in a pediatric population. J Oral Maxillofac Surg 2010; 68: 1310-1316.
    CrossrefPubMedGoogle Scholar
  • 14 Huber E. Electrophysiology of the retraction syndromes. Br J Ophthalmol 1974; 58: 293-300.
    CrossrefPubMedGoogle Scholar
  • 15 Jaensch PA. Paresen der schrägen Heber (Fall 2, Obl.-inferior-Pseudoparese). Graefes Arch Ophthalmol 1928; 121: 113-125.
    CrossrefGoogle Scholar
  • 16 Kaufmann H, Steffen H. Augenmuskeloperationen. In: Kaufmann H, Steffen H. (Hrsg). Strabismus Stuttgart, New York: Thieme; 2012: 550-592.
    Google Scholar
  • 17 Kodsi SR, Younge BR. Acquired oculomotor, trochlear, and abducent cranialnerve palsies in pediatric patients. Am J Ophthalmol 1992; 114: 568-574.
    CrossrefPubMedGoogle Scholar
  • 18 Lee JM, Kim SH, Lee JI. et al. Acute comitant esotropia in a child with a cerebellar tumor. Korean J Ophthalmol 2009; 23: 228-231.
    CrossrefPubMedGoogle Scholar
  • 19 Legmann SA, Borchert M. Etiology and prognosis of acute, late-onset esotropia. Ophthalmology 1997; 104: 1348-1352.
    CrossrefPubMedGoogle Scholar
  • 20 Lyons CJ, Tiffin PAC, Oystreck D. Acute acquired comitant esotropia: a prospective study. Eye 1999; 13: 617-620.
    CrossrefPubMedGoogle Scholar
  • 21 Mehanna P, Mehanna D, Cronin A. White-eyed blowout fracture; another look. Emerg Med Australas 2009; 21: 229-232.
    CrossrefPubMedGoogle Scholar
  • 22 Mohney BG. Common forms of childhood esotropia. Ophthalmology 2001; 108: 805-809.
    CrossrefPubMedGoogle Scholar
  • 23 Mulvihill A, Murphy M, Lee JP. Desinsertion of the inferior oblique muscle for treatment of superior oblique palsies in children. Pediatr Ophthalmol Strabismus 2000; 37: 279-282.
    Google Scholar
  • 24 Naik UV, Agarkar S, Swaminathan M, Surendran TS. Spontaneous late-onset comitant acute nonaccomodative esotropia in children. Indian J Ophthalmol 2008; 56: 90-91.
    CrossrefPubMedGoogle Scholar
  • 25 Phillips LH, Torner JC, Anderson MS, Cox GM. The epidemiology of myasthenia gravis in central and western Virginia. Neurology 1992; 42: 1888-1893.
    CrossrefPubMedGoogle Scholar
  • 26 Pieh C, Lagrèze WA. Angeborene Fehlinnervationssyndrome. Ophthalmologe 2007; 104: 1083-1095.
    CrossrefPubMedGoogle Scholar
  • 27 Robb RM. Idiopathic superior oblique palsies in children. J Ped Ophth Strab 1990; 27: 66-69.
    Google Scholar
  • 28 Schreuders J, Schwartzenberg GWST, Bos E, Versteegh FGA. Acute-onset esotropia: Should we look inside?. J Ped Ophth Strab 2012; 49: e70-e72.
    Google Scholar
  • 29 Simon JW, Waldman JB, Couture KC. Cerebellar astrocytoma manifesting as isolated, comitant esotropia in childhood. Am J Ophthalmol 1996; 121: 584-586.
    CrossrefPubMedGoogle Scholar
  • 30 Sires BS, Stanley RB, Levine LM. Oculocardic reflex caused by orbital floor trapdoor fracture: an indicaton for urgent repair. Arch Ophthalmol 1998; 116: 955-956.
    PubMedGoogle Scholar
  • 31 Steffen H, Kolling GH. Heterotropie. In: Kaufmann H, Steffen H. (Hrsg). Strabismus. Stuttgart, New York: Thieme; 2012: 221-262.
    Google Scholar
  • 32 VanderPluym J, Vajsar J, Jacob FD. et al. Clinical characteristica of pediatric myasthenia: a surveillance study. Pediatrics 2013; 132: e939-e944.
    CrossrefPubMedGoogle Scholar
  • 33 Wang NC, Ma L, Wu SY. et al. Orbital blow-out fractures in children: characterization and surgical outcome. Chung Gung Med J 2010; 33: 313-320.
    Google Scholar
  • 34 Williams AS, Hoyt CS. Acute comitant esotropia in children with brain tumors. Arch Ophthalmol 1989; 107: 376-378.
    CrossrefPubMedGoogle Scholar