1/139. Clinical features and surgery for acquired progressive esotropia associated with severe myopia.PURPOSE: The purpose of this study was to evaluate the clinical and physiological findings and to determine the most appropriate surgical procedure for acquired progressive esotropia with severe myopia. methods: Thirty-eight cases of acquired progressive esotropia with severe myopia were examined to evaluate their clinical and physiological findings. All cases were divided into four groups according to the limitation of their abduction. The eyeball in group IV is fixed in an extremely adducting position. Thirty-one cases underwent strabismus surgery; medial rectus muscle recession and lateral rectus muscle resection in 23 cases, transposition of superior and inferior rectus muscles (modified Jensen procedure included) in eight cases. RESULTS: The medial rectus muscle recession with the lateral rectus muscle resection procedure was effective in the early stage of acquired progressive esotropia patients. Transposition procedure was effective in the severe abducting limited patients. CONCLUSIONS: As the recession & resection procedure is easier than the transposition procedure, we recommend performing surgery in the earlier stage of the abducting disorder before the eyeball is fixed in an extremely adducting position.- - - - - - - - - - ranking = 1keywords = eye (Clic here for more details about this article) |
2/139. Intact sensory fusion in a child with divergence paresis caused by a pontine glioma.PURPOSE: To describe a child with divergence paresis esotropia caused by a brain tumor with intact sensory and motor fusion. METHOD: Case report. RESULTS: A 9-year-old boy who had one episode of double vision was initially seen with a small, variably present esophoria at near vision, an intermittent 10 prism diopter esotropia at distance, and stereopsis of 80 arc seconds. A magnetic resonance imaging examination disclosed a 4.0 x 4.5-cm pontine glioma. CONCLUSIONS: Ophthalmologists should recognize that the presence of intact sensory and motor fusion in a child with acute, comitant esotropia of the divergence paresis type does not preclude intracranial abnormality. If immediate neuroimaging is deferred, repeated thorough ocular motility examinations are warranted to detect progression.- - - - - - - - - - ranking = 0.52084782060973keywords = ocular (Clic here for more details about this article) |
3/139. Treatment of acute comitant esotropia in Chiari I malformation.PURPOSE: To explore the appropriate treatment of acute comitant esotropia in patients with Chiari I malformation. DESIGN: Interventional case reports and literature review. PARTICIPANTS: Two patients with Chiari I malformation presenting with acute comitant esotropia are described. INTERVENTION: strabismus surgery, then neurosurgical decompression of the Chiari I malformation was performed. MAIN OUTCOME MEASURE: Both patients were evaluated for resolution of esotropia and other ocular motility problems. RESULTS: After initially successful strabismus surgery, both patients developed recurrent esotropia with diplopia, which resolved on suboccipital decompression. CONCLUSION: Comitant esotropia may recur and other eye movement disorders may develop after initially successful strabismus surgery in patients with Chiari I malformation. The data suggest that the appropriate sequence of treatment should first be suboccipital decompression, then strabismus surgery if spontaneous realignment does not occur, but further studies are needed to confirm this impression.- - - - - - - - - - ranking = 1.0208478206097keywords = ocular, eye (Clic here for more details about this article) |
4/139. recurrence of cyclic esotropia after surgical correction.Cyclic esotropia is a rare form of strabismus in which a convergent squint appears and disappears typically, but not always, in a regular 48-hour cycle. Characteristically, the convergent squint, when present, has a large angle with associated suppression and no binocular function. On normal or "nonsquinting" days, no manifest deviation is detectable (although in some cases there may be an esophoria). Physiologic diplopia is appreciated, whereas fusion and stereopsis are all normal. amblyopia may occur in up to 20% of cases.- - - - - - - - - - ranking = 0.52084782060973keywords = ocular (Clic here for more details about this article) |
5/139. Etiology and surgical management of horizontal pontine gaze palsy with ipsilateral esotropia.INTRODUCTION: An esotropia ipsilateral to a horizontal pontine gaze palsy has been infrequently reported. We discuss the etiology and review the surgical management of this ocular motility defect. methods: Four patients with radiographically documented dorsal pontine lesions and persistent horizontal gaze palsy with esotropia ipsilateral to the gaze palsy were treated. In each patient, the esotropia was present in attempted primary gaze, producing symptomatic diplopia. An anomalous face turn was required to attain single binocular vision. RESULTS: All 4 patients underwent surgical correction to alleviate the anomalous head position and diplopia. Bilateral, asymmetric surgery was required to achieve a long-term successful result. Single binocular vision in the primary position with elimination or marked improvement of the compensatory head posture was initially achieved in all 4 patients. One patient, who had not undergone asymmetric strabismus surgery to reconcile incomitance produced by the esotropia, rapidly developed a residual esotropia. CONCLUSIONS: Ophthalmologists should recognize that concurrent esotropia may occur in patients with horizontal pontine gaze palsy. Single binocular vision in the primary position, an expanded binocular visual field, and alleviation of a compensatory head position are achievable with strabismus surgery.- - - - - - - - - - ranking = 2.6042391030486keywords = ocular (Clic here for more details about this article) |
6/139. Microstrabismus in monozygotic twins.PURPOSE: To report microesotropia in twins as a unique example of the role of heredity in primary microstrabismus. methods: Clinical records of the examinations of monozygotic twins with primary microstrabismus were reviewed. RESULT: Microstrabismus with different clinical findings was present in monozygotic twins. The family history and personal history of the patients were not significant. CONCLUSION: Microstrabismus can be seen as primary ocular motility problem without previous infantile esotropia or anisometropia. Genetic factors as well as intrauterine environment and developmental factors may affect sensorimotor development of the infant and cause ocular motility problems. Both twins should be examined for ocular motility disorders even in the absence of complaints.- - - - - - - - - - ranking = 1.5625434618292keywords = ocular (Clic here for more details about this article) |
7/139. Vergence disorders in patients with spinocerebellar ataxia 3/machado-joseph disease: a synoptophore study.diplopia, a common symptom in spinocerebellar ataxia 3/machado-joseph disease (SCA3/MJD) cases, is not always due to asymmetric ophthalmoplegia. We found a Japanese SCA3/MJD family, in which three patients clearly had an impairment of divergence eye movement. We thus quantitatively examined the vergence ranges in eight Japanese SCA3/MJD cases using the synoptophore test. An impairment of the vergence eye movements was found in all patients, and the vergence impairment pattern, but not the ophthalmoplegia pattern, was found to be compatible with the diplopia pattern. The diplopia in SCA3/MJD cases is, therefore, attributed, at least in part, to the impairment of the vergence eye movements.- - - - - - - - - - ranking = 1.5keywords = eye (Clic here for more details about this article) |
8/139. strabismus surgery in children with mobius syndrome.mobius syndrome is a congenital disorder of facial diplegia associated with lateral gaze paralysis. Although palsy of the sixth and seventh cranial nerves is the minimum diagnostic finding for mobius syndrome, neuropathologic evidence indicates that this is a more complex syndrome.(1) Clinically, it is characterized by a total absence of facial expression and severe esotropia. Other anomalies may be associated with this syndrome, especially other cranial nerve palsies and poland syndrome. The etiology of this syndrome has not been clearly established. brain stem necrosis resulting from a vascular deficiency has been offered as a possible pathogenetic explanation.(2) The strabismus in mobius syndrome is congenital esotropia with bilateral limitation in abduction. Even though many reports have described the various features of mobius syndrome, only a few articles have reported the results of strabismus surgery in children, including bimedial rectus muscle recession. (3-5) Some authors report that bilateral medial rectus muscle recession alone has been disappointing; therefore, a combination of a medial rectus muscle recession and a lateral rectus muscle resection was recommended for satisfactory results. (5-7) In more severe cases, muscle transposition was needed to ensure straight position of the eyes in primary gaze. (8-9)- - - - - - - - - - ranking = 0.5keywords = eye (Clic here for more details about this article) |
9/139. Ocular deviation after unilateral laser in situ keratomileusis.Laser keratomileusis and excimer laser photorefractive keratectomy in situ are widely used therapies for treating myopia. The corrections of refractive error by glasses or contact lens result in a relatively equal refractive correction on both eyes. However, refractive surgery on a single eye can cause a focus disparity between both eyes and may result in the impairment of fusion leading to strabismus. This article aims to report a case where diplopia and esotropia occurred 1 month after laser keratomileusis (LASIK) in situ for the correction of myopia.- - - - - - - - - - ranking = 1.5keywords = eye (Clic here for more details about this article) |
10/139. Isolated comitant esotropia and Chiari I malformation.PURPOSE: To report four patients with isolated comitant esotropia and Chiari I malformation and discuss the most appropriate management. methods: case reports and literature review. RESULTS: All four patients (5, 14, 16, and 37 years of age) presented with an isolated comitant esotropia that led to the diagnosis of Chiari I malformation. The first two patients underwent uncomplicated neurosurgical decompression of their malformation, followed by complete resolution of their esotropia. The third patient underwent strabismus surgery and experienced initial resolution of the esotropia, but eventual recurrence resulted in the strabismus surgery being repeated 5 years later. The fourth patient had strabismus surgery with resolution of the esotropia but only 2 months of follow-up. CONCLUSION: Although management of patients with Chiari I malformation and severe neurologic findings typically includes surgical decompression, management is less straightforward in cases with subtle findings or in which ocular findings are isolated. The decision to perform neurosurgical decompression or strabismus surgery should still be made on a case-by-case basis, with the understanding that strabismus surgery may provide only temporary ocular alignment.- - - - - - - - - - ranking = 1.0416956412195keywords = ocular (Clic here for more details about this article) |
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