1/54. Fresnel prism treatment of sensory exotropia with restoration of sensory and motor fusion.Anterior segment surgeons may treat patients with long-standing media opacities or uncorrected aphakia who have developed sensory strabismus. These patients are at risk for diplopia after surgery to clear the visual axis and restore emmetropia. This report describes 2 patients who regained comfortable single binocular vision without strabismus surgery. Sensory fusion was restored with Fresnel prisms, which were weaned and ultimately discarded as the patients' motor fusion was re-engaged after decades of disuse. Surgeons who restore vision in an eye with manifest sensory strabismus should be aware of this noninvasive, well-tolerated treatment option. Collaboration with an orthoptist or strabismologist may be helpful.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
2/54. Clinical characteristics of charge syndrome.charge syndrome, first described by Pagon, was named for its six major clinical features. They are: coloboma of the eye, heart defects, atresia of the choanae, retarded growth and development including CNS anomalies, genital hypoplasia and/or urinary tract anomalies, and ear anomalies and/or hearing loss. We experienced three cases of charge syndrome who displayed ocular coloboma, heart defects, retarded growth and development, and external ear anomalies, and we also review the previously reported literature concerning charge syndrome.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
3/54. Autogenous fascia augmentation of a partially extirpated muscle with a subperiosteal medial orbitotomy approach.INTRODUCTION: Endoscopic sinus surgery can result in serious extraocular muscle dysfunction. The medial rectus muscle is more frequently affected than other extraocular muscles. methods: A transconjunctival subperiosteal medial orbitotomy was successful in retrieving a partially extirpated medial rectus muscle after endoscopic sinus surgery. RESULTS: A previous attempt to localize this muscle by conventional surgery with extensive exploration was unsuccessful. A Hummelsheim procedure was also abandoned after a rupture of the nasal aspect of the inferior rectus muscle occurred. CONCLUSION: The approach we describe allowed adequate visualization of the posterior orbital content, as well as adequate space for suture placement.- - - - - - - - - - ranking = 2keywords = ocular (Clic here for more details about this article) |
4/54. The role of vergence adaptation in recovery of binocular single vision (BSV) following sensory strabismus.Vergence adaptation is an important element of comfortable binocular single vision and probably contributes to the high incidence of orthophoria or small angles of heterophoria in the normal population. Where binocular single vision has been absent for a period of time, restoration of good visual acuity appears to enable the vergence adaptation mechanism to become active again. A case is presented in which a moderate to large angle of deviation rapidly 'disappeared' once good visual acuity was restored and the disparate images could be fused. Known factors concerning vergence adaptation are discussed in relation to such clinical cases.- - - - - - - - - - ranking = 6keywords = ocular (Clic here for more details about this article) |
5/54. Ophthalmic manifestations of angelman syndrome.In 1965, Angelman described 3 cases of what he called "Puppet" children, named for the characteristic signs associated with what is now known as angelman syndrome, including mental retardation, speech impairment, easy excitability, and frequent spontaneous laughter.(1) Since that report, much progress has been made in defining the syndrome's clinical manifestations and understanding its molecular foundations, including identification of deletions of 15q11-13 in some patients. There are few reports in the ophthalmic literature regarding ocular manifestations of this syndrome. (2,3) We present the case of a child with strabismus associated with angelman syndrome, and we review the ophthalmic and systemic findings, as well as recent advances in molecular genetics, in these patients.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
6/54. Marcus Gunn jaw winking with trigemino-abducens synkinesis.Congenital ocular aberrant innervation syndromes are a complex group of disorders involving abnormal miswiring of the extraocular muscles. This case report describes a child with both a right Marcus Gunn jaw winking phenomenon and a right trigemino-abducens synkinesis, which has not previously been reported in the literature. Clinically, this child presented with an intermittent elevation of the right eyelid and/or an intermittent right exotropia when opening her mouth while sucking or chewing. This case suggests the primary abnormality in this patient may be abnormal development of the trigeminal nerve resulting in the eyelid abnormalities and strabismus.- - - - - - - - - - ranking = 2keywords = ocular (Clic here for more details about this article) |
7/54. eye deviation in patients with one-and-a-half syndrome.To understand malalignments of the visual axes in one-and-a-half syndrome, we measured eye positions in 4 patients with this syndrome under two conditions: with Frenzel goggles to prevent eye fixation and without Frenzel goggles. When fixation was prevented with the Frenzel goggles, all patients showed mild outward deviation in both eyes. Removal of the Frenzel goggles elicited adduction of the eye ipsilateral to the side of the lesion for fixation, with greater outward deviation of the contralateral eye (acute stage), or adduction of both eyes to midposition for biocular fixation (convalescent stage). In 3 patients whose outward eye deviation with Frenzel goggles was greater on the ipsilateral side, a transition from one-and-a-half syndrome to ipsilateral internuclear ophthalmoplegia was noted, whereas a transition to ipsilateral gaze palsy was seen in the one patient whose deviation was greater on the contralateral side. These findings suggest that in one-and-a-half syndrome patients, the eyes tend to be in divergent positions when fixation is prevented; ipsilateral eye deviation may result from medial longitudinal fasciculus involvement, and contralateral eye deviation may result from paramedian pontine reticular formation involvement. Viewing a target may lead to a secondary deviation or adaptation of eye positions for fixation.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
8/54. A case of Marcus Gunn jaw winking and pseudo inferior oblique overaction.PURPOSE: To report the association of Marcus Gunn jaw-winking phenomenon and pseudo inferior oblique overaction. methods: Case report. RESULTS: A 21-year-old woman presented with right eyelid elevation on the chewing movement since infancy. Examination showed that both Marcus Gunn jaw-winking phenomenon and pseudo inferior oblique overaction coexist in this patient. CONCLUSION: The association of Marcus Gunn jaw winking and pseudo inferior oblique overaction in one patient is reported. This coexistence in our case may provide some support to the existing concept that both phenomena are caused by an ocular aberrant innervation.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
9/54. Bilateral inferior insertion of lateral rectus muscles associated with schizencephaly.A 5-year-old boy with a large V-pattern exotropia is described. He has a background of congenital left hemiparesis associated with schizencephaly. At the time of surgery the lateral recti were found to be abnormally inferiorly positioned. Accordingly, both lateral rectus muscles were recessed 6.5 mm and supraplaced. A V-pattern exotropia persisted postoperatively with clinical overaction of the inferior obliques. To our knowledge this is the first known case of extraocular muscle abnormalities associated with schizencephaly.- - - - - - - - - - ranking = 1keywords = ocular (Clic here for more details about this article) |
10/54. Patient with purely extraocular manifestations from a pit viper snakebite (agkistrodon halys brevicaudus).Snake venom can cause myriad local and systemic signs and symptoms. Neurotoxic effects include difficulty seeing, diplopia, difficulty in opening the mouth, speaking, or swallowing, and difficulty getting out of bed the morning after the snakebite. Because of the unique structure of the extraocular muscles, they are particularly susceptible to the neurotoxin. Rarely, though, are symptoms of snakebite confined to the extraocular muscles. This case report describes a patient who experienced only extraocular manifestations of envenomation. It is important for clinicians to recognize this unique neurotoxic manifestation and to begin treatment of snakebites, because delay in treatment could cause permanent injury and even death.- - - - - - - - - - ranking = 7keywords = ocular (Clic here for more details about this article) |
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