Spectrum of childhood strabismus seen at Lagos University Teaching Hospital, Lagos, Nigeria

Abstract

Background: Strabismus is the misalignment of the visual axes of the eyes. It may lead to the development of amblyopia, impaired reading performance, absent or reduced binocular single vision as well as reduced self-esteem.

Objectives: To describe the spectrum of childhood strabismus seen at Guinness Eye Centre of the Lagos University Teaching Hospital, Lagos, Nigeria with a view to determining the most common type of strabismus as well as associated probable risk factors.

Methods: A retrospective, descriptive study of all new patients below the age of 16 years who were diagnosed to have strabismus (squint) at the Guinness Eye Centre, Lagos University Teaching Hospital between January, 2012 and December, 2015. Their case files were retrieved and relevant information extracted. Information obtained included age at presentation, gender, duration of symptoms before presentation, presenting visual acuity and family history of strabismus in first degree relatives. Also, type of strabismus, extent of deviation, refraction, ocular and systemic comorbidities, pregnancy, delivery as well as developmental history were extracted.

Results: One hundred and sixty-six new cases of children below 16 years of age with strabismus were seen during the period under review constituting 9.1% of 1,815 new paediatric ophthalmic presentations during the same period. There were 105 (63.3%) females with a male to female ratio of 1:1.7. The most common types of strabismus were alternating, constant, comitant and esotropia documented in 83 (53.0%), 139 (83.7%), 159 (95.8%) and 108 (65.1%) patients respectively. Forty-five (41.7%) out of the 108 patient with esotropia had congenital/infantile esotropia being the most common while the most common type of exotropia was intermittent seen in 22 (43.2%) out of the 51 exotropic patients. Hypermetropia was significantly associated with esodeviation (p=0.04) while myopia was significantly associated with exodeviation (p=0.003). Also, positive family history of strabismus in first degree relatives was found to be associated with exodeviation.

Conclusion: The most common type of childhood strabismus in this study was comitant strabismus (based on variability with gaze) and esotropia (based on direction of deviation).

Keywords: Spectrum, Childhood, Strabismus, Nigerian, Hospital