Complex Strabismus: Restriction, Paresis, Dissociated Strabismus, and Torticollis

Wright, Kenneth W.

doi:10.1007/0-387-27925-3_10

Cited by 6 publications

(7 citation statements)

References 112 publications

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“…Congenital fibrosis may occur in the extraocular muscles, often the medial rectus muscle, causing convergent strabismus fixus. [8] However, this syndrome is hereditary, nonprogressive, and is often accompanied by ptosis. Our case reported that the esotropia was progressive, ptosis was not present, and there was no family history of strabismus.…”

Section: Discussionmentioning

confidence: 99%

Convergent strabismus fixus after bilateral abducens nerve palsies due to aneurysms

Oku¹,

Nishikawa²,

Tonari³

et al. 2018

Medicine

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Rationale:Convergent strabismus fixus is an ocular motor abnormality in which the eye is fixed in adduction. This condition is mostly associated with high myopia and is caused by a displacement of the extraocular muscles. We report a nonmyopic woman with convergent strabismus fixus due to aneurysms.Patient concerns:A 79-year-old woman complained of progressive worsening of esotropia about 50 years prior to her visit. Neuroimaging showed that the eye was not dislocated, and the extraocular muscles were not displaced. However, aneurysms were found bilaterally from the intracavernous carotid arteries and the location was on both abducens nerves.Diagnoses:Chronic bilateral abducens nerve palsies due to aneurysms.Interventions:Endovascular treatment was successfully performed for the aneurysms.Outcomes:Convergent strabismus fixus still remained.Lessons:Chronic abducens nerve palsies may develop to nonmyopic convergent strabismus fixus without displacement of extraocular muscles, and mass lesions in the brain including aneurysms should be ruled out when orbital MRI cannot explain the condition.

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Section: Discussionmentioning

confidence: 99%

Convergent strabismus fixus after bilateral abducens nerve palsies due to aneurysms

Oku¹,

Nishikawa²,

Tonari³

et al. 2018

Medicine

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“…21 Some authors argue that conjunctival incisions made at the fornix spare the conjunctiva-Tenon's capsule junction and are therefore less likely to cause ischemia than incisions made at the limbus. 22 The Jensen procedure (muscle joining technique) is known to preserve ciliary circulation to some degree, but it is not a definitive solution. 23 The minimally invasive strabismus surgery (MISS) technique described by Mojon 24 reduces the risk of anterior segment ischemia by sparing the perilimbal episcleral vessels.…”

Section: Discussionmentioning

confidence: 99%

Anterior Segment Ischemia After Strabismus Surgery

Ra¹,

Ec²,

Me³

et al. 1994

Journal of Neuro-Ophthalmology

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A 46-year-old male patient was referred to our clinic with complaints of diplopia and esotropia in his right eye that developed after a car accident. The patient had right esotropia in primary position and abduction of the right eye was totally limited. Primary deviation was over 40 prism diopters at near and distance. The patient was diagnosed with sixth nerve palsy and 18 months after trauma, he underwent right medial rectus muscle recession. Ten months after the first operation, full-thickness tendon transposition of the superior and inferior rectus muscles (with Foster suture) was performed. On the first postoperative day, slit-lamp examination revealed corneal edema, 3+ cells in the anterior chamber and an irregular pupil. According to these findings, the diagnosis was anterior segment ischemia. Treatment with 0.1/5 mL topical dexamethasone drops (16 times/day), cyclopentolate hydrochloride drops (3 times/day) and 20 mg oral fluocortolone (3 times/day) was initiated. After 1 week of treatment, corneal edema regressed and the anterior chamber was clean. Topical and systemic steroid treatment was gradually discontinued. At postoperative 1 month, the patient was orthophoric and there were no pathologic symptoms besides the irregular pupil. Anterior segment ischemia is one of the most serious complications of strabismus surgery. Despite the fact that in most cases the only remaining sequel is an irregular pupil, serious circulation deficits could lead to phthisis bulbi. Clinical properties of anterior segment ischemia should be well recognized and in especially risky cases, preventative measures should be taken.

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“…[24][25] ( Figure 3) The patient can have a component of both pseudoptosis and true ptosis. (Figure 4) In these cases when the patient is made to fix with the affected eye the ptosis recovers only partly.…”

Section: -23mentioning

confidence: 99%