External or internal ophthalmoloplegia will result in a complete or a partial ocular dysmotility leading to a debilitating and variable manifest binocular diplopia for a majority of the patients. Complete third, forth and sixth nerve cranial nerve palsies are among the many number of etiologies appearing as paralytic strabismus. Successful clinical management, elimination of symptomatic diplopia in the primary field of gaze and increased binocular field of motor and sensory fusion as a result of the oculomotor nerve (III) palsy are challenging tasks for physicians facing this difficult clinical entity. Here we report a novel surgical technique in the clinical management of this disease through suture-fixation of medial rectus muscle onto Titanium plate (T-plate) already anchored into the nasal orbital wall.

Choroidal neovascularization (CNV) is a rare condition in children but poses a substantial threat to vision. Anti-vascular endothelial growth factor (anti-VEGF) therapy is commonly used in the pediatric population to treat retinopathy of prematurity. However, the use of anti-VEGF is less common for childhood CNV due to the rarity of CNV in the pediatric population. We report the case of a 10-year-old male presenting with an idiopathic choroidal neovascular membrane. Following a relapse of subretinal fluid after photodynamic therapy, anti-VEGF (bevacizumab) was injected and resulted in remission of the neovascular membrane and improved visual outcome. Further studies are required to elucidate the long-term outcomes associated with the use of anti-VEGF in pediatric patients.