Cases reported "Exotropia"

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11/82. 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.
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ranking = 1
keywords = exotropia
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12/82. Vision loss associated with a stiff neck complicating strabismus surgery.

    An exotropic 60 year old suffered a scleral-choroidal penetration and vitreous hemorrhage during and after strabismus surgery on a highly myopic eye when her anesthetic airway management was complicated by her previously asymptomatic and unrecognized rigid cervical spine which placed both the surgeon and the anesthetist in disadvantaged positions both physically and medically. Restoration of vision and binocularity ultimately required vitrectomy and intraocular lens implantation.
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ranking = 0.0070165617310757
keywords = strabismus
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13/82. diplopia as a complication of laser in situ keratomileusis surgery.

    A case is presented of a patient with high myopia who developed vertical binocular diplopia after decentred laser in situ keratomileusis (LASIK) surgery with associated decompensation of pre-existing exophoria into an exotropia. A 40-year-old man underwent LASIK surgery for high myopia in his right eye. Preoperatively, he was approximately -26.00/-2.00 x 35 degrees with visual acuity of 6/12(-2) in that eye. He also had an asymptomatic exophoria. After LASIK surgery, he achieved a refraction of -3.25/-0.50 x 80 degrees with 6/21 best-corrected visual acuity. He also developed binocular diplopia. The ablation zone had been decentred upwards and there was also an exo- and hypo-deviation of his right eye. He was able to superimpose the two images in free space with vertical and horizontal prisms.A hard contact lens also resulted in superimposition of the two images.Vertical decentration of the ablation zone can induce a vertical prism effect after LASIK surgery and result in vertical diplopia. This together with abnormal optics also caused loss of best-corrected vision and decompensation of his pre-existing exophoria into an exotropia.
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ranking = 1.0875582102004
keywords = exotropia, exophoria
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14/82. Esophageal smooth muscle tumor in a 25-year-old woman with congenital malformations.

    We recently treated a 25-year-old woman with an esophageal smooth muscle tumor with congenital malformations. Although the large size of the tumor and the presence of hemonecrotic lesion suggested the tumor to be leiomyosarcoma, histological studies revealed it to be leiomyoma. According to previous reports in the English-language literature, the coincidence of esophageal smooth muscle tumor with congenital malformations is relatively rare, and the coincidence of such a tumor with malformations of the type seen in this patient has never been reported. The congenital malformations in our patient were ocular hypertelorism, platyrrhiny, bilateral divergent strabismus, clubbed fingers and toes, fingerprint abnormality, and mild mental retardation. These congenital malformations cannot be explained by any reported syndromes.
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ranking = 0.0014033123462151
keywords = strabismus
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15/82. Clinical and oculographic response to Dexedrine in a patient with rod-cone dystrophy, exotropia, and congenital aperiodic alternating nystagmus.

    PURPOSE: We report a child with retinal dystrophy and congenital (a)periodic alternating nystagmus (APAN) who responded immediately with improved visual function and electrooculographic parameters after taking the psychopharmacologic stimulant Dexedrine Spansule (Glaxo-Smith Kline, NC, USA) as part of treatment for his attention Deficit Disorder. DESIGN: Interventional case report. methods: General ophthalmic, ocular motor and sensorimotor examinations and ocular motility recordings were performed before and after administration of the drug Dexedrine Spansule. RESULTS: The patient's binocular visual acuity improved only at 1.5 after medicine hours from 20/63 to 20/50, his exotropic deviation decreased from 25 to 10 prism diopters, his stereopsis increased from none to 800 sec/arc and ocular motility recordings showed increased foveation periods and more and lengthened APAN transition/null zones. CONCLUSION: For unexplained reasons the stimulant Dexedrine "paradoxically" improved the nystagmus, binocular function and visual acuity in this patient with retinal dystrophy and congenital nystagmus. This observation may be the basis for investigation of a new pharmacological treatment approach to patients with congenital nystagmus or strabismus.
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ranking = 2.0014033123462
keywords = exotropia, strabismus
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16/82. garlic and the strabismus surgeon.

    Potential side-effects caused by complementary medicines are often not anticipated. A case is reported of bilateral retro-bulbar haemorrhages with elevated intraocular pressure during strabismus surgery that occurred as a result of odourless garlic tablet ingestion prescribed by a naturopath. A near-catastrophic event was averted with rapid recognition and medical treatment. This is believed to be the first such report of haemorrhaging in ophthalmic surgery induced by garlic. It is concluded that unregulated naturopathic prescribing is potentially dangerous; doctors need to ask specifically about naturopathic potions.
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ranking = 0.0070165617310757
keywords = strabismus
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17/82. Refractive surgery for refractive errors which cause strabismus. A report of 8 cases.

    PURPOSE: While excimer laser refractive surgery is a well known procedure for correcting refractive errors, its use in adult patients with accommodative or partially accommodative esotropia who wish to remove their glasses, and those with high anisometropia and exotropia has not been extensively studied. We report our experience treating these two conditions with refractive surgery. methods: A retrospective review of the records of 8 adult patients with stable refractive error who underwent refractive surgery by the LASIK procedure. Three patients had accommodative esotropia, 3 had partially accommodative esotropia, and two patients had myopic anisometropia and exotropia. RESULTS: The LASIK refractive treatment corrected the strabismic deviation related to the hyperopia in the accommodative and partially accommodative esotropic patients. It also corrected the exotropia in the myopic anisometropic patients with exotropia. CONCLUSIONS: Refractive surgery is effective in treating accommodative and partially accommodative esotropia in adults and in cases of myopic anisometropia with exotropia.
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ranking = 2.5056132493849
keywords = exotropia, strabismus
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18/82. A case of paradoxical diplopia in large-angle consecutive exotropia.

    PURPOSE: To describe the investigation and subsequent management of paradoxical diplopia in unsightly exotropia. A 32-year-old lady requested surgical correction of a large manifest consecutive exotropia which, on initial correction with any base-in prism, was accompanied by paradoxical diplopia. methods: Botulinum toxin to the right lateral rectus reduced the deviation to 30 delta over a one-week period. The residual deviation was corrected with base-in Fresnel prisms which the patient wore constantly for another two weeks. Although there was demonstrable diplopia initially, it disappeared after 3-4 days of prism wear. Surgery was carried out comprising right lateral rectus recession (6 mm) and right medial rectus advancement from 12 mm to 6 mm posterior to the limbus. RESULTS: There was no diplopia following the surgery and the residual exodeviation measured 6 delta for near and 16 delta for distance (fixing OD). The patient remains symptom-free and cosmetically excellent. CONCLUSION: A gradual progressive reduction in the deviation using a combination of Botulinum toxin and prisms allowed a more informative conclusion to be made regarding the potential post-operative sensory status in this patient, by allowing her to slowly adjust to an altered ocular alignment. In patients with non-functional strabismus who may be at risk from post-operative diplopia, a trial with prisms over a few weeks with or without the addition of Botulinum toxin is advocated.
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ranking = 3.0014033123462
keywords = exotropia, strabismus
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19/82. Alternating ptosis associated with intermittent exotropia.

    A unique case of alternating, poorly controlled, intermittent strabismus that improved after repair of bilateral, alternating congenital ptosis is described. A 7-year-old boy with bilateral, alternating congenital ptosis and poorly controlled, intermittent exotropia underwent bilateral frontalis suspensions. After surgery, the patient demonstrated improved control of his exotropia. We conclude that an alternating ptosis may lead to sensory deprivation of the occluded eye and decreased fusion, causing an intermittent strabismus to be poorly controlled. Repair of the ptosis to a sufficient eyelid height bilaterally may improve control of the strabismus, obviating strabismus surgery.
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ranking = 3.0056132493849
keywords = exotropia, strabismus
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20/82. Case report: Extraocular muscle paresis caused by snakebite.

    A 51 year-old man presented with binocular diplopia on the three days after the snakebite in the fifth finger of the right hand by an agkistrodon blomhoffi (mamushi). In the primary position he had an exotropia and right hypertropia, which became apparent when his head was tilted to the right. From ocular angle of deviation measured by synoptophore and Hess chart test, he was diagnosed as having medial rectus muscle paresis as well as inferior oblique muscle paresis of the left eye. Elevation deficit on right gaze in the left eye had remained during three days. Our case suggested that the occurrence of subjective binocular diplopia is an important clinical sign for the onset of general abnormalities caused by snakebite.
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ranking = 0.5
keywords = exotropia
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