Department of Ophthalmology, University Hospitals Leuven, Leuven.
Faculty of Medicine, KU Leuven, Leuven.
Strabismus. 2022 Jun;30(2):59-64. doi: 10.1080/09273972.2022.2046113. Epub 2022 Mar 15.
We investigated a possible association between the acute onset of esotropia and tablet or smartphone use in children. We characterized the clinical aspects of esotropia associated with tablet or smartphone use. The medical records of 10 children aged between 5 and 15 years old with presumably tablet or smartphone associated esotropia were reviewed regarding orthoptic examination and cycloplegic refraction. Legal guardians of the children were asked to fill in a questionnaire regarding tablet and smartphone use of their child. This questionnaire was also conducted in a control group of age-matched children. The results of this questionnaire were compared to search for possible determinants of tablet or smartphone associated esotropia. All 10 patients presented with a comitant esotropia ranging from 8 to 45 prism diopters with no significant difference between near and far. The mean age of onset was 9.8 years. Cycloplegic refraction showed a mild hyperopia in eight patients, a mild myopia in one patient and emmetropia in the other patient. All patients had near full refractive correction at the onset of esotropia. Diplopia was reduced after visual hygiene recommendations, however in six patients, strabismus surgery was needed. The working distance was significantly shorter in the 10 cases compared to the controls. In children with acute acquired esotropia, we found a statistically significant association with a smaller working distance during tablet or smartphone use compared to age-matched controls. We hypothesize that intensive near viewing can be a precipitating factor in this type of esotropia.
我们研究了儿童内斜视急性发作与平板电脑或智能手机使用之间的可能关联。我们对与平板电脑或智能手机使用相关的内斜视的临床特征进行了描述。我们回顾了 10 名年龄在 5 至 15 岁之间的可能因平板电脑或智能手机导致内斜视的儿童的病历，内容涉及斜视检查和睫状肌麻痹验光。我们还要求这些儿童的法定监护人填写一份关于其子女平板电脑和智能手机使用情况的问卷。我们还在年龄匹配的对照组中进行了这项问卷调查。我们比较了这些问卷的结果，以寻找可能导致与平板电脑或智能手机相关的内斜视的决定因素。所有 10 名患者均表现为共同性内斜视，斜视度为 8 至 45 棱镜度，近距和远距斜视度无显著差异。发病的平均年龄为 9.8 岁。睫状肌麻痹验光显示 8 名患者有轻度远视，1 名患者有轻度近视，1 名患者为正视。所有患者在发病时均有近距全矫视力。在接受视觉卫生建议后，复视有所改善，但仍有 6 名患者需要斜视手术。与对照组相比，这 10 例患者的工作距离明显缩短。在急性获得性内斜视儿童中，我们发现与年龄匹配的对照组相比，平板电脑或智能手机使用时工作距离较小与斜视的发生有统计学上的显著关联。我们假设近距离密集观看可能是这种类型斜视的诱发因素。
