Clinical Characteristics and Outcomes of Smartphone Overusers with Acute Acquired Comitant Esotropia

Jiho Song; Sa Kang Kim; Mi Young Choi

doi:10.3341/jkos.2018.59.2.169

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Song, Kim, and Choi: Clinical Characteristics and Outcomes of Smartphone Overusers with Acute Acquired Comitant Esotropia

Original Article

Journal of the Korean Ophthalmological Society 2018; 59(2): 169-175.

Published online: 9 February 2018

DOI: https://doi.org/10.3341/jkos.2018.59.2.169

Clinical Characteristics and Outcomes of Smartphone Overusers with Acute Acquired Comitant Esotropia

Jiho Song, MD, Sa Kang Kim, MD, PhD, Mi Young Choi, MD, PhD

Department of Ophthalmology Chungbuk National University College of Medicine, Cheongju, Korea.

Address reprint requests to Mi Young Choi, MD, PhD. Department of Ophthalmology, Chungbuk National University Hospital, #776 1sunhwan-ro, Seowon-gu, Cheongju 28644, Korea. Tel: 82-43-269-6146, Fax: 82-43-269-6148, mychoi@chungbuk.ac.kr

Received 3 August 2017 Revised 22 October 2017 Accepted 23 January 2018

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the clinical features and treatment outcomes of smartphone overusers with acute acquired comitant esotropia.

Methods

We retrospectively reviewed the medical records of patients ≥ 15 years of age who used a smartphone for > 4 hours a day for > 1 year, and who were diagnosed with acute acquired comitant esotropia from May 2011 to January 2016. We analyzed sex, age at the time of manifestation and duration of esotropia, refractive error, deviated angle at the first and final visits, and the results of refraining from smartphone use, use of the Fresnel prism, and surgery for esotropia.

Results

A total of 13 patients were studied, including 8 males and 5 females. The mean age at development of esotropia was 22.7 ± 9.7 years. The mean duration of esotropia before the first visit was 28.0 ± 33.0 months, and the mean follow-up period was 16.4 ± 16.4 months. The mean angle of esotropia was 21.8 ± 7.0 prism diopters (PD) at distance and 22.2 ± 7.9 PD at near. There were eight myopic patients; the other patients were emmetropia. The esotropia of all patients did not improve after refraining from smartphone use. There was no improvement in five patients who were wearing the Fresnel prism for ≥ 4 months. A total of six patients were treated with bilateral medial rectus recession; only one patient remained orthotropic at postoperative 6 months, three patients were undercorrected, and two had a recurrence.

Conclusions

Esotropia persisted after refraining from smartphone use or wearing a Fresnel prism in acute acquired comitant esotropia patients who were smartphone overusers, and the surgical prognosis of these patients was relatively poor.

Keywords: Acute acquired comitant esotropia, Fresnel prism, Medial rectus recession, Smartphone, Surgical outcome

Figures and Tables

Figure 1

The course after first surgery of 6 patients who were performed bilateral medial rectus recession. Only one patient (Case 2) achieved orthotropia at postoperative 6 months. Two patients (Case 1, 3), showed good alignment within 10 prism diopter at postoperative 1 week, but the angles of esotropia were increased. The other 3 patients were undercorrected.

Table 1

Demographic characteristics of patients

‘−’ means ‘myopia’ and ‘+’ means ‘hyperopia’.

BCVA = best corrected visual acuity; Rt = right; Lt = left; PD = prism diopter; F= female; M = male.

Table 2

Clinical characteristics of Fresnel prism treatments

PD = prism diopter; F= female; M = male.

Table 3

Surgical outcomes

PD = prism diopter; F= female; M = male; BMR = bilateral medial rectus recession; BLR = bilateral lateral rectus; RMR = right medial rectus recession; RLR = right lateral rectus recession.

Notes

This study was presented as a narration at the 116th Annual Meeting of the Korean Ophthalmological Society 2016.

^{Conflicts of Interest} The authors have no conflicts to disclose.

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