Sutter F K P, Landau Klara
Department of Ophthalmology, University Hospital Zurich, Switzerland.
Swiss Med Wkly. 2003 May 17;133(19-20):293-4. doi: 10.4414/smw.2003.10206.
We report on a series of patients with acute strabismus related to heroin and methadone intake or withdrawal, discuss possible mechanisms involved in this clinical picture and make recommendations for work-up and referral.
Retrospective study.
Five patients presented with acute esotropia within days of heroin withdrawal, and two patients developed exotropia related to heroin or methadone intake. Neurological work-up and neuroimaging was non-contributory in all four patients who were examined.
Acute esotropia with double vision is a disturbing side effect of heroin withdrawal, and, similarly, acute exotropia may be related to heroin intake. In the absence of focal neurological signs, further work-up is not mandatory. Referral to a specialised orthoptic service is beneficial in offering the patient symptomatic treatment and reassurance, thus supporting successful withdrawal therapy.
我们报告了一系列与海洛因和美沙酮摄入或戒断相关的急性斜视患者，讨论了这种临床情况可能涉及的机制，并对检查和转诊提出建议。
回顾性研究。
5例患者在海洛因戒断数天内出现急性内斜视，2例患者出现与海洛因或美沙酮摄入相关的外斜视。在接受检查的所有4例患者中，神经学检查和神经影像学检查均无异常发现。
伴有复视的急性内斜视是海洛因戒断令人不安的副作用，同样，急性外斜视可能与海洛因摄入有关。在没有局灶性神经体征的情况下，无需进一步检查。转诊至专业的斜视治疗机构有利于为患者提供对症治疗和安慰，从而支持成功的戒毒治疗。
