Tag: strabismus

Is Ocular Palsy a Vaccine Injury?

Now why would anyone think that an ocular palsy could be caused by vaccines?

There is no real evidence that a cranial nerve six palsy, which causes strabismus or esotropia, is a common vaccine injury, even though Dr. Bob focused on it recently.

Is Ocular Palsy a Vaccine Injury?

What is Dr. Bob’s evidence?

A vaccine injury story from a vaccine hesitant mom who was giving her child one vaccine at a time and who became cross-eyed five days after getting the MMR vaccine.

“It is an absolutely, 100% well known vaccine reaction to live virus vaccines as you eventually discovered, it’s called ocular palsy.”

Bob Sears

Is that true?

Not exactly.

It is true that there are a handful of case reports of toddlers developing a cranial nerve six palsy after a live virus vaccine, but that doesn’t make it an “absolutely, 100% well-known vaccine reaction.”

Why not?

The story Dr. Bob tells could be published as a case report. But that wouldn’t be proof that it was caused by the MMR vaccine, as other causes weren’t ruled out, and it is easy to overlook that the child had just had a double ear infection.

“Benign isolated 6th nerve palsy of childhood is rare, and recurrences are rarer. By definition, it is not due to a threatening cause, such as an underlying intracranial lesion, and recovery is expected. This condition typically occurs following viral illnesses, infections, and immunization involving attenuated live vaccinations. In general, prognosis for benign recurrent 6th nerve palsy is excellent, and majority of patients recover full muscle function.”

Gonçalves et al on Benign Recurrent Sixth Nerve Palsy in a Child

Could the child that Dr. Bob talks about have had a viral infection causing their sixth nerve palsy?

Sure. The child even had a double ear infection the previous month.

Considering that in most of the case reports, the children developed symptoms later, between 7 or 21 days to as late as 6 weeks to 6 months after their vaccine, then the previous ear infection starts to look like a more likely cause, not the MMR vaccine.

“A previously healthy four-year-old girl was presented to our emergency room with complaints of binocular horizontal diplopia of sudden onset and strabismus.”

Gonçalves et al on Benign Recurrent Sixth Nerve Palsy in a Child

What’s different about the four-year-old girl discussed above and the child Dr. Bob talks about?

“One week prior to the event, the child had a history of fever and productive cough, and she was under treatment with amoxicillin. There was no history of live attenuated vaccine administration in the previous days.”

Gonçalves et al on Benign Recurrent Sixth Nerve Palsy in a Child

This child wasn’t recently vaccinated.

There are also case reports of children developing recurrent 6th nerve palsy without any obvious trigger – no immunization and no recent infection.

And cases from the 1950s and 60s and earlier, before we had an MMR vaccine.

“This syndrome is not a new entity, and experienced clinicians recall cases in which the combination of only fever and VI nerve palsy cautioned them against other diagnostic measures. Sir Charles Symonds, in a discussion recorded in the proceedings of the Royal Society of Medicine, makes reference to his observations of patients in whom VI nerve palsy followed febrile illness and was of no consequence. In the same discussion he also mentions instances in which VI nerve palsy followed otitis media, and yet there was no pain and little constitutional disturbance. The palsy he considered to be the result of an aseptic thrombosis of the inferior petrosal sinus, adjacent to the VI nerve as it passes through Dorello’s canal.”

Knox et al on Benign VI Nerve Palsies in Children

Also consider that if a live attenuated vaccine is causing such a vaccine injury, then wouldn’t you expect kids with natural measles infections to develop these 6th nerve palsies at equal, or more likely, greater rates.

What about those case reports from the 1950s and 60s and earlier? No, those early case reports weren’t about kids with measles.

The bottom line is that if you want to consider this type of ocular palsy a vaccine injury, you should also explore the possibility that it was caused by an infection or by chance. And the only folks who would say 100% that these incidents are a vaccine injury, when there is just as much, if not more, evidence saying they aren’t, are those who think that everything is a vaccine injury

More on Medical Exemptions

Do Vaccines Cause Strabismus?

Vaccines can do a lot of things.

They can prevent you from getting a life-threatening disease, sometimes even after you have been exposed. And if you do get sick when vaccinated, the vaccine can often help to make sure the disease isn’t as severe as it might have been if you were unvaccinated. They can also keep you from getting sick and exposing others, including those who are at extra risk for severe disease.

Vaccines also get blamed for doing a lot of other things, namely for causing vaccine injuries.

These types of vaccine injury stories often scare other parents away from vaccinating and protecting their kids.
These types of vaccine injury stories often scare other parents away from vaccinating and protecting their kids.

While, of course, vaccines aren’t risk free, they don’t actually cause most of the bad things you read about on the Internet.

What Causes Strabismus?

Strabismus isn’t a disease. It is simply a term that describes a misalignment of your child’s eyes.

“At birth, an infant’s eyes cannot always focus directly on objects. They may appear to move quite independently at first, sometimes crossing, and sometimes wandering outward. But by the age of three to four months, an infant’s eyes should have the ability to focus on small objects and the eyes should be straight or parallel. A six-month-old infant should be able to focus on both distant and near objects.”

Prevent Blindness America on Is Strabismus Present at Birth?

To be more specific, children with strabismus can have:

  • esotropia – the eye turns inward
  • exotropia – the eye turns outward
  • hyertropia – the eye turns upward
  • hypotropia – the eye turns downward

And we get especially concerned when strabismus leads to amblyopia – decreased vision in the affected eye.

Some specific things that cause strabismus include:

  • third nerve (III) palsy
  • fourth nerve (IV) palsy – superior oblique muscle
  • sixth nerve (VI) palsy – lateral rectus muscle
  • Brown syndrome
  • Duane syndrome

Often, we don’t know why kids have strabismus, although it is thought that at least 50% of them are born with it, even if it isn’t recognized until they are older.

“Most strabismus is the result of an abnormality of the neuromuscular (including brain) control of eye movement. Our understanding of these control centers in the brain remains incomplete. Less commonly, a problem with the actual eye muscle may cause strabismus.”

AAPOS on What causes strabismus?

Kids with cerebral palsy, Down syndrome, hydrocephalus, and brain tumors are thought to be at higher risk for developing strabismus.

Do Vaccines Cause Strabismus?

And because we don’t always know what causes strabismus, that leads some folks to want to blame vaccines.

Interestingly, one study, Prevalence of Amblyopia and Strabismus in White and African-American Children Aged 6 through 71 Months: The Baltimore Pediatric Eye Disease Study, found that strabismus was rare in infants and that while higher in older kids, “there was no clear trend for increasing or decreasing prevalence after age 12 months.”

If strabismus was caused by vaccines, wouldn’t you expect to see more infants with strabismus and a consistent rise in cases as kids continued to get vaccines until they go to kindergarten?

Do any studies support the idea that vaccines do cause strabismus?

No.

There are a few case reports, but it is important to remember that a case report is basically a gloried anecdote. It is not the kind of high quality evidence you really want if you are trying to make a case trying to prove causality.

The biggest evidence against vaccines causing strabismus?

Strabismus isn’t new.

The first cases were reported over 3500 years ago and the first surgical repairs were being done in the early 19th Century.

So why do some folks think that strabismus is a vaccine injury? Mostly it is because some folks think that everything is a vaccine injury.

More on Strabismus