CLINICAL PROFILE OF COMITANT HORIZONTAL STRABISMUS IN 0-20 YEARS OF AGE: A STUDY FROM RURAL MAHARASHTRA

Introduction: Strabismus, a misalignment of the eyes, is a significant ocular disorder affecting children and young adults. Comitant horizontal strabismus is characterized by a consistent angle of deviation regardless of direction of gaze. It can impact visual development and psychosocial well-being. Understanding its clinical profile is essential for improving diagnosis, treatment, and management strategies, especially in rural healthcare settings.

Objectives: This study aims to analyse the clinical characteristics, distribution patterns, and associated factors of comitant horizontal strabismus in individuals aged 0-20 years in a rural tertiary care hospital in Maharashtra.

Materials and Methods: A cross-sectional, observational study was conducted over two years in the ophthalmology department of a tertiary care hospital. A total of 40 patients aged 0-20 years diagnosed with comitant horizontal strabismus were enrolled. Clinical assessments included visual acuity testing, cycloplegic refraction, ocular movement evaluation, cover tests, prism and alternate cover tests and amblyopia assessment. Data was entered into excel and analysed as percentages and proportions.

Results: Among the 40 patients, 42.5% had esotropia, while 57.5% had exotropia. Esotropia was more prevalent in younger children (0-5 years), whereas exotropia increased with age. Esotropia was strongly associated with hypermetropia (76.47%), while exotropia was linked with myopia (60.87%). Amblyopia was more common in esotropic cases (23.53%) than in exotropic cases (17.39%). Exotropia was predominantly intermittent (73.91%), whereas esotropia was constantly present in all cases.

Conclusion: This study highlights the predominance of exotropia over esotropia, the strong refractive error associations, and the significant presence of amblyopia in strabismic patients. Early detection and appropriate intervention are crucial in preventing visual impairment and addressing the psychosocial challenges associated with strabismus. Further large-scale studies can enhance our understanding of the epidemiology and management of comitant horizontal strabismus in underserved populations.