J Korean Ophthalmol Soc.  2021 Jun;62(6):820-825. 10.3341/jkos.2021.62.6.820.

The Effect of Near-work on the Development of Delayed-onset Consecutive Esotropia

• Kang E
• Ha SG
• Kim SH

• KMID: 2516810
• DOI: http://doi.org/10.3341/jkos.2021.62.6.820

Abstract

Purpose
To identify the correlation between near work and the occurrence of delayed-onset consecutive esotropia after surgery for intermittent exotropia.
Methods
A survey and retrospective review were conducted on patients in two groups. The study included patients who visited from January 2019 to January 2020. Patients who re-developed esodeviation after recovering orthophoria after the initial postoperative overcorrection for the surgical correction of intermittent exotropia were included in the delayed-onset esotropia group (Group 1), and patients with persistent orthotropia for at least 3 years after bilateral lateral rectus recession for intermittent exotropia were included in Group 2. We evaluated the daily frequency and hours of distance/near work in both groups.
Results
A total of 42 patients were evaluated. Preoperative exodeviation at a distance was 28.5 ± 4.4 prism diopters (PD) in group 1 and 30.5 ± 5.2 PD in group 2, with no significant difference between the two groups. The percentages of patients who chose two or more extremely near-work activities a day were 47.8% and 15.8% for groups 1 and 2, respectively; these values were statistically significant (p = 0.02). Twelve patients in Group 2 answered “watching TV” (63.2%) as the most common activity, which was statistically significant compared to Group 1 (26.1% in Group 1, p = 0.02). The total numbers of hours of extremely near-work a day were 2.7 ± 2.1 and 1.5 ± 1.2 hours for groups 1 and 2, respectively, which was also statistically significant (p = 0.037).
Conclusions
We found a significant correlation with occurrence of delayed-onset consecutive esotropia with the frequency and hours of extremely near-work after bilateral lateral rectus recession for intermittent exotropia. More attention to extremely near-work should be considered carefully after bilateral lateral rectus recession for intermittent exotropia.

Keyword

Bilateral lateral rectus recession; Consecutive esotropia; Intermittent exotropia; Near-work; Smartphone