Prevalence and Clinical Features of Sagging Eye Syndrome in Korean Patients

Abstract

Purpose: To retrospectively analyze the relative frequency and describe the clinical features of sagging eye syndrome in Koreanpatients from a single center. Methods: We retrospectively analyzed the medical records of patients with diplopia, aged over 40 years, who visited ChosunUniversity Hospital from January 2018 to December 2020. The relative frequency of sagging eye syndrome was examined byclassifying the cause of diplopia. Clinical features, such as age, sex, strabismus type, angle of deviation, treatment method,and prognosis were evaluated. Results: A total of 128 patients were identified, of which 23 (18%) were diagnosed with sagging eye syndrome, including 12male patients (52.2%) and 11 female patients (47.9%). Their mean age was 74.6 ± 7.6 years (range, 61–89 years), and all patientswere over 60 years. Among the 62 patients with diplopia and age over 60 years, the relative frequency of sagging eyesyndrome was 23 (37.1%), the highest among all age groups. Among the 23 patients with sagging eye syndrome, nine patients(39.1%) had only distance esotropia, with a mean distance esotropia value of 10.1 ± 8.6 prism diopters (PD) (range, 4–25 PD)at the first visit; nine patients (39.1%) had a combination of esotropia and vertical strabismus, with a mean esotropia valueof 6.2 ± 4.8 PD (range, 2–12 PD) and a vertical angle of 4.7± 3.2 PD (range, 2–10 PD); and five patients (21.7%) had only verticalstrabismus, with an average vertical strabismus angle of 3.3 ± 1.6 PD (range, 4–8 PD). Furthermore, 17 out of 23 patients(73.9%) used prism glasses, in whom the symptoms of diplopia disappeared. Finally, only three patients (13.0%) underwentsurgery. Conclusions: Sagging eye syndrome in Korean patients was identified in those over 60 years with a similar male-to-femaleratio. Moreover, nonsurgical treatments, such as prism glasses, largely helped relieve the symptoms of sagging eye syndrome.