Trudności w leczeniu zezów u dorosłych z guzami mózgu
Difficulties in Strabismus Treatment in the Course of Brain Tumors in Adults
Lidia Puchalska-Niedbał, Urszula Kulik, Małgorzata Kaska
Katedra i Klinika Okulistyki Pomorskiego Uniwersytetu Medycznego w Szczecinie
Kierownik: dr hab. n. med. Wojciech Lubiński, prof. nadzw. PUM, FEBO
Summary: Purpose: In general, concomitant convergent strabismus is considered harmless, however the sudden appearance of strabismus may be a sign of central nervous system disease. The aim of our study is to describe therapeutic problems which occur in adult patients who reported to Outpatient Strabismus Clinic due to the sudden occurrence of squint.
Material and Methods: The study group consisted of 21 patients (11 men, 10 women) treated for brain tumor (38% conservative, 62% with surgery) in whom strabismus had suddenly appeared. Patients mainly complained of double vision. Among the patients 2/3rd of adults had convergent strabismus and 1/3rd had divergent one, in 6 cases vertical deviation was observed. The following examinations were performed: visual acuity, strabismus angle, eye movements and binocularity by subjective, Sobański, Bagolini tests and with synoptophore.
Results: The average onset of strabismus in adults was 39.6 years old. Strabismus angles were from 4° to 34° (16° average) before treatment. Improvement took place after treatment. Recovery i.e. orthoposition, decreased squint angle, lack of diplopia or development of normal binocular vision was observed in most of the cases.
Conclusions: Treatment of strabismus secondary to brain tumor requires a long treatment phase because of the difficulty in overcoming persistent double vision. Widening of the angle or lack of the response of medical treatment was observed in patients with recurrent brain tumor deterioration. Managing such patients extends over time, the patient requires frequent changes of prismatic correction as well as the patience from both the patient and ophthalmologist.
Słowa kluczowe: zez, guz mózgu, dorośli.
Keywords: strabismus, brain tumor, adults.