Session: Poster session A

Preoperative Stereoacuity Assessment in Children with Constant Esotropia

Introduction:  Although some children with constant esotropia can develop normal stereopsis postoperatively, there is currently no known preoperative test to predict postoperative stereoacuity. The purpose of this pilot study was to preoperatively assess stereoacuity using the synoptophore on children with a constant esotropia.

 

Methods:  The medical records of esotropic children undergoing synoptophore evaluation at our institution from October 1, 2021, through September 30, 2023, were retrospectively reviewed. Preoperative stereoacuity assessments were performed at distance (Frisby David and Randot Stereo Test), near (Preschool Randot, Frisby, and Titmus), and with the synoptophore using the Braddick Random Dot Slides (range, 90 to 720 seconds) after neutralizing their subjective angle. 

 

Results:  Five children (mean age 9 years; range, 6.4 to 13.5) with a mean constant angle of esotropia of 26 PD (range, 16 to 40) were included. Three of the children demonstrated 180 seconds or better of preoperative stereoacuity using the synoptophore but 400 seconds or worse using the Randot stereo testing without the synoptophore. All 3 demonstrated normal alignment and 40 seconds of stereopsis following surgery. The two remaining children demonstrated 400 seconds or worse preoperative stereoacuity with the synoptophore and no improvement following successful surgery.

 

Conclusions:  Preoperative stereoacuity assessment using the synoptophore successfully predicted the stereoacuity outcomes in 5 patients with constant esotropia. The use of the synoptophore in the preoperative assessment may be predictive for clinicians and families alike regarding the postoperative potential for binocular function.