China
Africa
Explore chapters and articles related to this topic
Clinical Aspects
Published in Marc H. De Baets, Hans J.G.H. Oosterhuis, Myasthenia Gravis, 2019
If a patient with ptosis is asked to close the eyes for some minutes, the ptosis usually decreases or disappears for a short time. Eye muscle pareses however usually do not improve after eye closure. In some patients the palpebral fissures become excessively widened after eye closure by the concomitant weakness of the mm. orbiculares oculi (Figure 5).
The Second Half of the Nineteenth Century
Published in Arturo Castiglioni, A History of Medicine, 2019
The new paths in ophthalmology opened by the discoveries of Helmholtz, von Graefe and Donders were being explored by many followers throughout the world. Here, as in other fields, the progress in pathology and bacteriology brought powerful help, while anesthesia and asepsis permitted tremendous advances in operative procedures. Cataracts could be removed safely and surely; the fistula operations for glaucoma and cyclodialysis, introduced by Heine, afforded to the eye surgeon a choice of methods, while L. laqueur’s (1839-1909) use of physostigmin as a miotic has proved most helpful in treating this important disease. Plastic surgery has been successful in correcting traumatic and paralytic deformities of the palpebral fissure. The ability to correct errors of refraction and accommodation has steadily increased with the addition of new diagnostic methods of precision and skill in the manufacture of bifocal lenses and those of various combinations of curves.
Head and neck
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
In this paper, Inigo describes a technique of levator lengthening using autologous conchal cartilage graft sutured between the tarsal plate and LA that was successful in 11 out of 12 patients. They demonstrated that the width of graft required to reduce the palpebral fissure by 1 mm is ~4 mm.
Extraocular Muscle Transplantation for Primary Treatment of Large-Angle Exotropia
Published in Journal of Binocular Vision and Ocular Motility, 2021
Shailja Tibrewal, Rajat Kapoor, Soveeta Souravee Rath, Virender Sachdeva, Ramesh Kekunnaya
Prior literature reports the use of muscle transplantation procedures in the primary correction of large-angle esotropia.4–6 The reported advantages of this procedure include: the ability to correct large-angle deviations with surgery on only two muscles, to limit the surgery to a single eye often the one with poor vision, and minimal detrimental effect on ocular motility. However, there is limited literature about using muscle transplantation procedures for primary large-angle exotropia and it is believed that they are less effective as compared to muscle transplantation for primary large-angle esotropia. Therefore, we performed this study to report the feasibility and outcomes of muscle transplantation combined with the conventional unilateral recess-resect procedure as primary surgery for large-angle (≥60PD) exotropia. We obtained a median correction of 62.5PD of exotropia with this procedure and 60% of the patients achieved motor success (≤10PD of orthotropia at the final follow-up). The postoperative abduction limit was minimal (≤−1 at the final follow-up). There were no intraoperative complications. Postoperative palpebral fissure changes were transient and did not persist beyond 6 weeks.
Minimal invasive vertical muscle transposition for the treatment of large angle exotropia due to congenital medial rectus hypoplasia: Case Report and Literature Review
Published in Strabismus, 2020
Mohammad Yaser Kiarudi, Aliakbar Sabermoghadam, Mahsa Sardabi, Seyed Vahid Jafarzadeh, Mohammad Etezad Razavi
An explanation for this mismatch of imaging and intraoperative observation has been proposed by Sharma and colleagues. Each extraocular muscle has two parts of orbital and global layers and these layers in embryological evolution develop separately. Orbital layer terminates early at muscle pulley system, adjacent to the equator of the globe. Only orbital layer in these cases may be present that terminates near the equator explaining observation of empty muscle sheath during surgery.13 One unusual feature of the case we introduced here was palpebral fissure widening in the affected side of hypoplasia. After surgery, palpebral fissure widening was corrected and palpebral fissure height decreased from 13 mm to 9 mm in primary position. However, in attempted adduction (Figure 4b), lid retraction was observed suggesting a dysinnervation pattern. In previous reports of medial rectus hypoplasia, in one case associated bilateral moderate ptosis has been reported.9
Isolated and Transient Nuclear Midbrain Blepharoptosis in a Young and Healthy Adult
Published in Neuro-Ophthalmology, 2020
Bulent Yazici, Gamze Ucan Gunduz, Nukhet Yargic
On examination, palpebral fissure heights were 2 mm OD and 1 mm OS. Levator excursions were 3 mm and 2 mm, respectively (Figure 1a). Except for mildly restricted abduction in the left eye, his extraocular eye movements were normal and the eyes were orthotropic. The pupils were isochoric and constricted to both light and near stimuli. The visual acuities were 20/20 OU. The other ocular findings were normal. Magnetic resonance imaging (MRI) demonstrated a lesion located predominantly on the left side of the dorsal caudal midbrain, which was 10 × 10 mm in diameter, iso-mildly hypointense on T1-weighted images and hyperintense on T2-weighted and fluid-attenuated inversion recovery images. The lesion showed contrast enhancement (Figure 2). Infectious diseases, immunology and haematology consultations, detailed blood tests and haemodynamic studies did not reveal any abnormalities.