Abstract：
PURPOSE:To evaluate whether nonrecovery from acute traumatic sixth nerve palsy could be predicted from demographic factors or palsy characteristics. DESIGN:Prospective, observational case series SETTING:Multicenter (academic and private practices). OUTCOME MEASURE:Nonrecovery, defined as the presence of diplopia in primary position or more than 10 prism diopters of distance esotropia in primary position at 6 months after onset. METHODS:Using data from a previously described cohort of 84 eligible patients with acute traumatic sixth nerve palsy, we performed multivariate analyses of demographic factors and palsy characteristics. RESULTS:Nonrecovery at 6 months after onset was associated with a complete palsy (adjusted risk ratio, 9.11; 95% confidence interval [CI], 2.77-14.84) and with a bilateral palsy or paresis (adjusted risk ratio, 2.53; 95% CI, 0.98-4.29). The choice of conservative management (observation, prism, or patch) versus acute injection of Botulinum toxin (within 3 months of injury) did not influence final recovery. CONCLUSIONS:In acute traumatic sixth nerve palsy or paresis, failure to recover by 6 months after onset was associated independently with inability to abduct past midline at presentation and bilaterality. Although the overall recovery rate is high in acute traumatic sixth nerve palsy or paresis, a complete or bilateral case has a poor prognosis and is more likely to need strabismus surgery.
journal_name
Ophthalmologyjournal_title
Ophthalmologyauthors
Holmes JM,Beck RW,Kip KE,Droste PJ,Leske DA,Pediatric Eye Disease Investigator Group.doi
10.1016/s0161-6420(01)00633-9subject
Has Abstractpub_date
2001-08-01 00:00:00pages
1457-60issue
8eissn
0161-6420issn
1549-4713pii
S0161-6420(01)00633-9journal_volume
108pub_type
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