Tendon elongation with a bovine pericardium implant is a safe surgical method, suitable to correct severe esotropia after decompression surgery. A lower dose-effect has to be taken into account. Patients with esotropia ≥42 should not be treated with unilateral, but bilateral tendon elongation, to avoid undercorrections. In patients with deviations ≥52 it has to be further investigated if the application of even higher elongation distances is viable or if another approach-the recession of more than one rectus muscle has to be performed simultaneously to handle the severe restriction. Generally, a step-by-step approach is advisable, since small vertical deviations could also be corrected in a third of patients with the procedure and the dose-effect was more variable as in medial recessions without tendon elongation.

While wearing bifocals the accommodative convergence excess decreased completely in patients with esophoria and microesotropia. In the condition with markedly reduced binocular vision and a large phoric component at far and near, the convergence excess decreased only in some of the patients while wearing bifocals. Conventional strabismus surgery to reduce the basic angle has a positive influence. A Fadenoperation is only necessary in a few cases.

Tracheobronchial lesions after blunt chest injury are rare. Diagnosis and therapy can prove to be challenging for the attending physician. Nonrecognition of this injury may entail severe complications. Herein we report the case of a 9-year-old girl with rupture of the trachea due to a fall against the handlebar of her kickboard. The clinical, radiological, and features of the therapy performed are discussed.

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