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Thyroid ophtalmopathy manifesting as superior oblique paralysis
Published in Jan-Tjeerd de Faber, 28th European Strabismological Association Meeting, 2020
V. Oğuz, M. Yolar, H. Pazarli, S. Özkan
The second possibility is the early myopathy of the inferior rectus of the eye responsible for the apparent paralysis of the superior oblique [9]. This condition may be interpreted as a subclinic infiltration presenting in the inferior oblique, and spreads through the neighbouring tissues and by the Lockwood ligament to the inferior oblique while inducing a hyperfonction in the latter. It is quite reasonable for such a condition of inferior rectus involvement in two eyes that is less severe in the eye which shows an upshoot in adduction, but this assumption does not explain the absence of inferior oblique hyperfunction of the eye in which the inferior rectus has been severely involved.
Head and neck
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Capsulopalpebral fascia (CPF) of the lower lid – this is a condensation of fibrous tissue that is analogous to the LA. It is an extension from the inferior rectus muscle to the tarsus and functions to stabilise the tarsus allowing the eyelid to descend when the eyeball looks down. It splits around the inferior oblique and then reunites at Lockwood’s ligament.
Orbital Fractures
Published in Jeffrey R. Marcus, Detlev Erdmann, Eduardo D. Rodriguez, Essentials of CRANIOMAXILLOFACIAL TRAUMA, 2014
Regina M. Fearmonti, Jeffrey R. Marcus
A pure blowout fracture involves the internal orbital walls without fracture of the orbital rims. On examination, diplopia and enophthalmos are frequently evident. Diplopia is most often the result of edema but can result from incarceration of the inferior oblique or inferior rectus muscles, Lockwood’s ligament. Tenon’s capsule, or periorbital fat within the fracture line, any of which may lead to restricted ocular movement. Similarly, direct damage to the extraocular muscles or their innervations, hematoma, or edema can also lead to diplopia.
Inferior oblique muscle belly transposition and myopexy for diplopia
Published in Strabismus, 2021
Pilar Merino-Sanz, Amanda Chapinal, Pilar Gómez de Liaño Sánchez, Fabio Zavarse Fadul
The purpose of this technique is to correct deviation in primary gaze position and mild or moderate upshoot in adduction. The surgical effect is greater or weaker depending on the point at which the muscle is sutured to the sclera.1 The limited literature published has demonstrated that inferior oblique muscle fixation to sclera 5 mm posterior to the temporal pole of the inferior rectus can correct small-angle hypertropia <5 pd in straight gaze and mild-to-moderate upshoot in adduction. This technique creates a new muscle insertion diminishing the contact arch of the muscle as it does for the posterior fixation of a rectus muscle or as a recession-resection, producing minimal effect in the primary position but reducing muscle function in its specific gaze. Leaving the origin and the insertion intact, a transposition will make the muscle tighter. That it still works, could be caused by a different direction of pull of the muscle and by the trauma to the muscle, caused by the myopexia and because the part of the inferior oblique muscle that courses over the globe, has been fixed to the globe in an extended position. The functional origin of the inferior oblique muscle is near the temporal border of the inferior rectus where this muscle becomes attached by its sheath to the suspensory Lockwood ligament.9–11
Anterior vestibule salvaging technique to limit silicone orbital implant extrusion following evisceration
Published in Orbit, 2019
Nicholas A. Moore, Roxana Fu, Jeremy Clark, Mark Prendes, William R. Nunery, Richard A. Burgett, H.B. Harold Lee
The incidence of non-integrated (silicone or acrylic) implant exposure or extrusion following eviscerations has been estimated up to 15%, which exceeds the 3.1% rate found in this study.17–19 Rates of exposure and extrusion are influenced by several factors including a history of previous ocular disease or ophthalmic surgery, implant type and size, the need for secondary implantation, and the type of surgical technique utilized.3,4 The exposure rates are higher among patients that have undergone previous ocular procedures or experienced acute trauma (comorbid ophthalmic conditions). Incidence also increases with placement of larger implants and implants composed of porous hydroxyapatite (mechanical factors). Furthermore, exposure rates are also higher following evisceration procedures when compared with enucleations.3,10,18 In contrast, migration rates are intuitively lower in evisceration where orbital fascial structures (intermuscular septae, Lockwood’s ligament, superior oblique) are not disrupted.
Primary orbital polymethylmethacrylate implant following primary enucleation for retinoblastoma: a study of 321 cases
Published in Orbit, 2021
Shikha Taneja, Tariq Aldoais, Swathi Kaliki
The spherical orbital implants have a tendency to slip between superior and lateral rectus muscle into the loose Tenon’s space resulting in supero-temporal migration of the orbital implants.32 The Lockwood ligament and the oblique muscles prevent the rolling of implant in inferior and nasal direction, respectively. In our study, the most common site of implant migration was supero-temporal (5%) cases.