Bilateral congenital hypertropic strabismus fixus: A case report

Abstract

Purpose: To report an unusual and rare case of both eyes fixed in an extreme superomedial position. Case report: A case of 48-year-old woman presented with both eyes fixed in an extreme superomedial position; the microcorneas were covered almost completely by the upper eyelids even when she opened her eyes. A forced duction test was performed to confirm there were severe restrictions in all directions. She underwent disinsertion of the superior and medial rectus muscle, inferior oblique muscle belly transposition and sclera fixation. At the 1-year follow-up, there was improved ocular alignment. Conclusion: This case may be a special form of myopic strabismus fixus. The infratemporal fossa may be a bony landmark related to the etiology of global fixation.

Modified partial Jensen procedure to treat a hypertropic Knobby eye syndrome in a high myopic monocular patient

“…In fact, a myope with bilateral fixed hypertropia and esotropia was also reported to have superior LR displacement with infratemporal globe herniation: a condition termed congenital hypertropic strabismus fixus by Li et.al. 10 These reports as well as ours support the importance of imaging in the assessment and planning of surgeries treating myopia-related strabismus, as mechanical changes in EOM vectors from staphylomata/globe contour might be the common etiology for these different pathologies.…”