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Strabismus Patterns in Patients with Intrauterine Drug Exposure

ABSTRACT Purpose This retrospective study evaluates the patterns of strabismus, the incidence of amblyopia, and prevalence of anatomical ocular pathology in patients with intrauterine drug exposure (IDE) presenting to a tertiary referral center for an ophthalmic evaluation. Methods We reviewed charts of patients who presented to our pediatric ophthalmology clinic from 8/2017-10/2018 with reported IDE. The mean age at presentation was 29 months. We documented the type of exposure, birth history, social history, and past medical and surgical history. Visual acuity, motility, fundus exam, and cycloplegic refraction were reviewed. Results Thirty-eight patients met the criteria. Motility exam showed that 23 patients were exotropic, 10 were esotropic, and 5 were orthophoric. Average angle of the exotropic deviation was 27ΔXT (range X 10 to XT 50). Amblyopia, nystagmus, and anatomical ocular anomalies also occurred frequently. Conclusion Strabismus and other eye diseases are common in patients with IDE. Exodeviations were the most common finding and occurred in 60.5% of our cohort. Patients with IDE are at a higher risk for treatable conditions such as strabismus and amblyopia. Possible history of IDE should be considered in infants who present with congenital strabismus, particularly exotropia.