Original Research

The prevalence of strabismus in schizophrenic patients in Durban, KwaZulu Natal

D. Ndlovu, S. Nhleko, Y. Pillay, T. Tsiako, N. Yusuf, R. Hansraj
African Vision and Eye Health | South African Optometrist: Vol 70, No 3 | a106 | DOI: https://doi.org/10.4102/aveh.v70i3.106 | © 2011 D. Ndlovu, S. Nhleko, Y. Pillay, T. Tsiako, N. Yusuf, R. Hansraj | This work is licensed under CC Attribution 4.0
Submitted: 11 December 2011 | Published: 11 December 2011

About the author(s)

D. Ndlovu, Discipline of Optometry, Faculty of Health Sciences, University of Kwazulu Natal, South Africa
S. Nhleko, Discipline of Optometry, Faculty of Health Sciences, University of Kwazulu Natal
Y. Pillay, Discipline of Optometry, Faculty of Health Sciences, University of Kwazulu Natal
T. Tsiako, Discipline of Optometry, Faculty of Health Sciences, University of Kwazulu Natal, South Africa
N. Yusuf, Discipline of Optometry, Faculty of Health Sciences, University of Kwazulu Natal
R. Hansraj, Discipline of Optometry, Faculty of Health Sciences, University of Kwazulu Natal

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Abstract

Purpose:    The psychosocial implications of a strabismus have not received sufficient attention and yet may have a significantly negative effect on a person’s life.  Schizophrenia is the fourth leading cause of mental disability in the developed world.  Both schizophrenia and strabismus appear to share a genetic and neurological origin.  This study thus set out to assess the prevalence of strabismus in a sample of schizophrenic subjects. Setting:  The study was carried out in Durban, Kwazulu-Natal inSouth Africa specifically at the Durban and Coastal Mental Health Institution. Method:  Fifty schizophrenic subjects residing at the Durban and Coastal Mental Health (DMH) Institution were assessedfor the presence of strabismus using the cover test and modified Krimsky test.  The inclusion criteria were all subjects diagnosed with schizophrenia, of both genders and any race.  The subjects werebetween fifteen to seventy years of age.  The exclusion criteria included any other mental illness, systemic disease or medication other than that usedon schizophrenic patients.  Results:   The prevalence of strabismus in this sample was found tobe 74% which was considerably higher than that
reported by other studies1,2.  There was a greater incidence of exotropia as opposed to esotropia.  The mean distance exotropia as detected with the cover test was 33 prism dioptres.  Similarly, the near cover test indicated a mean of 11 prism dioptres exotropia, and with the modified Krimsky test a mean of 9 prism dioptres exotropia.   Most of the strabismic subjects (86.5%) presented with a strabismus when fixating a near target.  Generally the strabismus was found to be constant and unilateral and no gender bias was found.  Conclusion:There appears to be a strong relationship between strabismus and schizophrenia.  Health care professionals, especially those dealing with paediatric care, parents and the public should be made awareof this relationship so that psychological adviceand early intervention can be sought for strabismic children. (S Afr Optom 2011 70(3) 101-108)


Keywords

Schizophrenia; strabismus; cover test; modified Krimsky test; heterotropia; genetics.

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