Evidence map›Paper›PMID 31526795›Full record

ArticleAmerican journal of ophthalmology2020

Prevalence of Sagging Eye Syndrome in Adults with Binocular Diplopia.

Toshiaki Goseki, Soh Youn Suh, Laura Robbins, Stacy L Pineles, Federico G Velez, Joseph L Demer

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of ophthalmology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 1 pooled it
4.6field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Functional Anatomy of Ocular Counter-Rolling in Superior Oblique Palsy.Investigative ophthalmology & visual science · 2025
    Article
  8. Observational
  9. Observational
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. [Vertical strabismus in the elderly].Die Ophthalmologie · 2024
    Article
  17. Doses of medial rectus muscle recessions for divergence insufficiency-type esotropia.Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2024
    Article
  18. Comparison of head tilt test between sagging eye syndrome and acquired unilateral trochlear nerve palsy.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2024
    Article
  19. Association of preoperative sensory monofixation with surgical failure in adult-onset divergence insufficiency-type esotropia.Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2023
    Article
  20. Comparison of subjective cyclofusion ranges and objective ocular torsion in normal participants according to age.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2022
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 2 countries.

Toshiaki GosekiDepartment of Ophthalmology, University of California Los Angeles, Los Angeles, California, USA; UCLA Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA; Department of Ophthalmology, Kitasato University School of Medicine, Sagamihara, Japan.
Soh Youn SuhDepartment of Ophthalmology, University of California Los Angeles, Los Angeles, California, USA; UCLA Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA.
Laura RobbinsDepartment of Ophthalmology, University of California Los Angeles, Los Angeles, California, USA; UCLA Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA.
Stacy L PinelesDepartment of Ophthalmology, University of California Los Angeles, Los Angeles, California, USA; UCLA Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA.
Federico G VelezDepartment of Ophthalmology, University of California Los Angeles, Los Angeles, California, USA; Department of Ophthalmology, Duke University, Durham, North Carolina, USA.
Joseph L DemerDepartment of Ophthalmology, University of California Los Angeles, Los Angeles, California, USA; UCLA Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA; Department of Neurology, David Geffen Medical School at University of California, Los Angeles, California, USA; Neuroscience Interdepartmental Program, David Geffen Medical School at University of California, Los Angeles, California, USA; Bioengineering Interdepartmental Program, David Geffen Medical School at University of California, Los Angeles, California, USA; David Geffen Medical School at University of California, Los Angeles, California, USA. Electronic address: jld@jsei.ucla.edu.
University of California, Los Angeles · US

Funding

Vision Research Core at UCLAP30EY000331 · NEI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Gregory Darin Field, DAVID S WILLIAMS · 1985 to 2026
$16.8M
BIOMECHANICAL ANALYSIS IN STRABISMUS SURGERYR01EY008313 · NEI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI JOSEPH Louis DEMER · 1991 to 2026
$15.0M
Data-Driven Biomechanical Simulation of Eye Movement and StrabismusR01EY029715 · NEI · GEORGE MASON UNIVERSITY · PI WEI, QI · 2019 to 2022
$1.5M
Physical Injuries in Patients with Pediatric Eye DiseasesR21EY029655 · NEI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI PINELES, STACY · 2019 to 2020
$429k
NEI NIH HHS P30 EY000331NEI NIH HHS R01 EY008313NEI NIH HHS R01 EY029715NEI NIH HHS R21 EY029655
6 · The paper itself

Abstract

purposeSagging eye syndrome (SES), horizontal and/or vertical strabismus caused by orbital connective tissue degeneration, was first defined 10 years ago. This study investigated SES and other causes of acquired binocular diplopia in adults presenting to a single institution since the description of SES.

designRetrospective observational case series.

methodsMedical records were reviewed of all new patients over the age of 40 who presented to the Stein Eye Institute with binocular diplopia between January 2015 and December 2018. Clinical causes of diplopia were tabulated in patients grouped by age and sex. In patients with SES, we tabulated binocular alignment, types of treatment, and surgical outcomes.

resultsThere were 945 patients of mean age 66.5 years, of whom 514 (54.4%) were female. The most common cause of diplopia was SES (31.4%). The 297 patients with SES were older at 71.2 years (P < 0.0001) and more predominantly female at 59.9% than other patients (52.0%; P = 0.023). The relative proportion of SES patients among all diplopic patients increased with age from 4.7% under age 50 years to 60.9% over the age of 90. Age-related distance esotropia was present in 35% and cyclovertical strabismus in 65% of cases of SES. Strabismus surgery was performed in 50% of cases of SES. Mean esotropia at distance decreased from 6.9 ± 0.7Δ preoperatively to 0.3 ± 0.3Δ postoperatively. Preoperative hypertropia decreased from 3.0 ± 0.3Δ to 0.7 ± 0.2Δ postoperatively. Surgery resolved diplopia in all cases.

conclusionsIt is important to recognize that SES is a very common cause of adult binocular diplopia.

Indexed as

AdultAgedAged, 80 and overAgingConnective Tissue DiseasesDiplopiaFemaleHumansMaleMiddle AgedOculomotor MusclesOphthalmologic Surgical ProceduresOrbital DiseasesPrevalenceRetrospective StudiesStrabismus

Identifiers

PMID31526795
PMCPMC6911643
OpenAlexW2972905614

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.