Demographic and Clinical Profile of Patients Undergoing Strabismus Surgery in Northeastern Brazil

A Profile of Strabismus Surgery in Northeastern Brazil

When a patient is referred to a tertiary hospital for strabismus surgery, they aren’t just a statistic in a clinical database; they represent a complex intersection of ocular misalignment, neurological health, and often, significant psychosocial challenges. A retrospective study published in Cureus has provided a detailed look at this specific patient population at the Hospital Universitário Professor Edgard Santos in Salvador, Brazil, revealing how demographic and clinical profiles shape the surgical landscape in the region.

By analyzing medical records from a five-year window between January 2017 and December 2022, researchers have mapped out the specific needs of 242 patients who underwent these procedures. The findings suggest that the patients arriving at this specialized referral center in northeastern Brazil present with distinct clinical characteristics—most notably a high prevalence of horizontal deviations and a significant link to hyperopia.

This data matters because tertiary referral hospitals often serve as the final stop in a regionalized healthcare network. In Brazil, the Unified Health System (Sistema Único de Saúde, or SUS) relies on these specialized hubs to handle complex cases that local clinics cannot. Because these hospitals receive the most difficult or specialized referrals, their patient profiles may differ significantly from the general population, acting more as a mirror for specialized surgical practice than a broad epidemiological census.

The Demographic and Clinical Reality of Surgical Patients

The study found that the patient group was notably young, with a mean age at the time of surgery of 16.3 years. While the age range spanned from infancy to 73 years, nearly half of the patients—48.8%—were 10 years old or younger.

Gender and specific ocular characteristics also emerged as defining features of the cohort:

Gender Distribution: Female patients made up 62.0% of the total group.
Deviation Type: Horizontal strabismus was the most common classification, appearing in 76.4% of cases, with esotropia (inward turning of the eye) accounting for 65.4% of those horizontal instances.
Refractive Status: Hyperopia (farsightedness) was the predominant refractive category, documented in 79.3% of patients.
Laterality: 60.3% of the patients presented with bilateral involvement, meaning the misalignment affected both eyes.

About 14.0% of patients documented an abnormal head posture, a common compensatory mechanism used to manage double vision or improve focus, while 11.2% reported diplopia (double vision).

Ocular and Systemic Comorbidities Affect Many Patients

Strabismus rarely exists in a vacuum. The Cureus report highlights that a significant portion of the surgical population dealt with additional medical complexities. Nearly a quarter of the patients (23.6%) were identified with ocular comorbidities, such as amblyopia or ptosis. Even more telling was the presence of systemic issues; 19.4% of the patients had documented systemic comorbidities, including neurological conditions and thyroid disorders.

Clinical Category	Prevalence in Study Population
Ocular Comorbidities	23.6%
Systemic Comorbidities	19.4%
Neurological Conditions (within systemic)	7.0%
Thyroid Disorders (within systemic)	3.3%
History of Trauma	9.5%

The data also points to the role of external factors and genetics. A history of physical trauma was documented in 9.5% of cases, and 7.9% of patients reported a family history of strabismus. These variables show that for many, strabismus is not merely a localized eye issue but a condition linked to their medical history and genetic makeup.