ArticleChildren (Basel, Switzerland)2023
Ocular Torsion in Children with Horizontal Strabismus or Orthophoria.
Article in Children (Basel, Switzerland), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 3 citations in OpenAlex.
- Simplifying the Diagnosis of Vertical Diplopia: Is It Skew or Not?Journal of eye movement research · 2026Article
- The consistency and efficacy of optical coherence tomography for the evaluation of ocular torsion angle in children.Frontiers in pediatrics · 2025Article
- Assessment of Ocular Torsion in Exotropic Patients Following Horizontal Strabismus Surgery: A Comparative Analysis Using Conventional Color Fundus Photography and Spectralis Optical Coherence Tomography.Journal of ophthalmology · 2025Article
- The changes in ocular torsion after unilateral lateral rectus recession-medial rectus resection for intermittent exotropia.Scientific reports · 2024Article
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo report the rate of ocular torsion in children with horizontal strabismus or orthophoria.
methodsA retrospective study design was used. Nineteen children were included in the study, including seven girls, aged 4-16 years. All patients were examined for strabismus and 12 were scheduled for surgical intervention. All participants had digital fundus photos (DRSplus, Padova, Italy) of both eyes at presentation, and 5 of 12 also had fundus photos following the strabismus operation. Patient files were reviewed for age, demographic data, type of strabismus, clinical symptoms and signs, orthoptic exams, subjective and objective reports of torsion, inferior oblique overaction, and V pattern. Fundus photos were analyzed for torsion by ImageJ software [ImageJ 1.54f, National Institute of Health, USA]. The disc-foveal angle was calculated for ocular torsion. Disc-foveal angle was defined as the angle formed between a line passing through the center of the optic disc to the fovea and another horizontal line passing through the center of the optic disc, using fundus photographs.
resultsOf the 19 children, 18 had horizontal strabismus: 9 with exotropia and 9 with esotropia. One child was orthophoric with torsional strabismus. Inferior oblique overaction was detected in all but 3 children, while V pattern was documented in 10. Visual acuity was reduced (under 6/12) in four eyes of four children. None were symptomatic for ocular torsion. Although extorsion was documented clinically in 3 of 19 children, it was measurable on fundus photos in all patients before surgery with a mean of 8.7 ± 8.5 degrees and 8.5 ± 9.7 degrees in the right and left eyes, respectively. The mean extorsion in both eyes was 19.7 ± 10.1 degrees and improved to a mean of 15.3 ± 7.9 degrees in the children who were operated on and had documented postoperative fundus photographs.
conclusionsExtorsion was detected on fundus photos at a significantly higher rate than in clinical examination. Notably, inferior oblique overaction was mainly associated with torsion. This study demonstrated that torsion is underdiagnosed in clinical examinations, as the children are often asymptomatic, but fundus photos which are easily obtained can improve its detection.
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