STRABISMUS IN THE MARFAN-SYNDROME

We studied 573 patients with the Marfan syndrome for the presence of o cular misalignment, refractive errors, and amblyopia. A total of 110 p atients (19.2%) had strabismus. Of 573 patients, exotropia occurred in 67 (11.7%), esotropia in 12 (2.1%), vertical deviations in eight (1.4 %), and primary inferior oblique muscle overaction in three (0.5%). Of 67 patients with exotropia, 18 had anisometropia and 39 had amblyopia . Of the 12 patients with esotropia, four had amblyopia and none had a nisometropia. Exotropia and esotropia are more common in patients with the Marfan syndrome than in the general population of,the United Stat es (P < .001 for exotropia and .05 < P < .10 for esotropia). Abnormal afferent visual inputs to cortical centers caused by ectopia lentis, c raniofacial abnormalities, and mechanical and genetic factors may all contribute to the higher prevalence of strabismus in this disease.