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All Journal Indonesian Journal of Case Reports Grimsa Journal of Science Engineering and Technology
Toshnowal, Nikhil
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Agriculture, Biological Sciences & Forestry Chemical Engineering, Chemistry & Bioengineering Engineering Health Professions Medicine & Pharmacology Neuroscience Physics Public Health

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The Impact of Missed Red Reflex Screening on Binocular Vision Outcomes in a Child with Bilateral Congenital Cataracts Fadliyani, Eka; Sari, Munita; Imelda, Eva; Anggreiny, Cut Dini; Toshnowal, Nikhil
Indonesian Journal of Case Reports Vol. 3 No. 2 (2025): December 2025
Publisher : Heca Sentra Analitika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.60084/ijcr.v3i2.355

Abstract

Delayed recognition of congenital cataracts during the critical period of visual development can result in permanent neurovisual deficits. This case report describes a 5-year-old child with bilateral congenital cataracts who presented late with alternating exotropia. Ocular evaluation showed bilateral cataracts, alternating fixation on cover testing, and absent stereopsis, indicating long-standing visual deprivation. Despite cataract extraction, binocular function remained poor due to disruption of cortical binocularity beyond the sensitive developmental window. This case underscores the irreversible impact of late intervention and highlights the need for strengthened neonatal red reflex screening and timely referral to prevent avoidable lifelong visual impairment.
Surgical Management of Manifest Exotropia and Its Effect on Cosmetic Appearance in Amblyopic Patients Imelda, Eva; Mahfiza, Cut Salsabila; Fadliyani, Eka; Toshnowal, Nikhil
Grimsa Journal of Science Engineering and Technology Vol. 4 No. 1 (2026): April 2026
Publisher : Graha Primera Saintifika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61975/gjset.v4i1.101

Abstract

Constant exotropia, defined by persistent outward deviation of the eye, can cause cosmetic concerns and disrupt binocular function if untreated. We report a case of a 26-year-old male with long-standing left-eye exotropia and amblyopia since early childhood. Preoperative assessment revealed a visual acuity of 6/30 in the left eye, 15° exotropia on Hirschberg testing, 30 prism diopters on prism alternate cover testing, alternating fixation with right-eye dominance, and left-eye suppression on the Worth Four Dot test. The patient underwent unilateral lateral rectus recession and medial rectus resection. One week postoperatively, ocular alignment was orthotropic with satisfactory cosmetic and motor outcomes, while functional binocular vision remained limited. This case demonstrates the effectiveness of surgical intervention in restoring alignment and appearance in adult sensory exotropia and emphasizes the importance of early detection and timely management to prevent irreversible sensory deficits.
Co-Authors Anggreiny, Cut Dini Fadliyani, Eka Imelda, Eva Mahfiza, Cut Salsabila Sari, Munita