1/110. 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. ( info) |
2/110. 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. ( info) |
3/110. Unexpected difficult intubation in the patient with Morning Glory syndrome. Morning Glory syndrome is an uncommon congenital optic disc anomaly with occasional systemic associations. A case of unsuspected difficult intubation in a three-year old patient is described in this case report. ( info) |
4/110. Disinsertion of the medial rectus following pterygium surgery: signs and management. The clinical characteristics, intraoperative findings and management of two cases of "lost" medial recti during surgery for recurrent pterygium are described. The lost muscles are classified in different groups according to their etiopathogenesis. In the cases reported, the muscles were found retroinserted with extensive proliferation of fibrous tissue. This complication was resolved after finding the muscle, liberating the surrounding fibrous tissue and reattachment in its original insertion. Two aspects stand out: The CAT scan to determine the location of the muscle and the usefulness of topical anesthesia to facilitate recognition of the muscle during the surgical procedure. ( info) |
5/110. Convergence insufficiency in idiopathic Parkinson's disease responsive to levodopa. We report a patient with pathologically proven idiopathic Parkinson's disease (IPD) who developed diplopia secondary to convergence insufficiency during his motor "off" periods. diplopia resolved with onset of motor benefit from levodopa. Neuro-ophthalmologic examination demonstrated convergence insufficiency during motor "off" periods that was alleviated after onset of motor benefit from levodopa. This is the first reported case of convergence insufficiency in IPD responsive to levodopa. ( info) |
6/110. 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. ( info) |
7/110. 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. ( info) |
| A case of waardenburg syndrome with unusual features such as anisocoria, exotropia is reported. ( info) |
| Ocular complications after spinal surgery are rare, although ischemic optic neuropathy, occipital lobe infarcts, and central retinal vein thrombosis have been reported. Our purpose is to report a case of an acute, comitant, postoperative exotropia that rapidly and spontaneously resolved. This case is particularly interesting in that it may indirectly shed some light on mechanisms of vergence control. ( info) |
10/110. Primary localized conjunctival amyloidosis following strabismus surgery. A 13-year-old white boy developed bilateral polypoid conjunctival masses overlying the lateral rectus muscles six months after surgery for divergent strabismus. Histologic examination confirmed the presence of amyloid in these lesions. ( info) |