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Bilateral duane’s syndrome Type I in siblings: Case Report
Published in Jan-Tjeerd de Faber, 28th European Strabismological Association Meeting, 2020
C. Schiavi, M. Fresina, F. Quagliano, E.C. Campos
Patient 2 was first examined when he was 20-months old. His eye-motility examination revealed the presence of bilateral Duane’s syndrome with absence of abduction in both eyes, restriction of adduction in either eye, bilateral narrowing of the palpebral fissure and retraction of the globe in adduction (Fig. 5). Orthophoria with stereopsis were present in primary position and the head posture was normal (Fig. 6). No pathological features were present in both eyes. When he was 5 years old visual acuity which was 6/6 bilaterally. Now he is 6 year old and at the moment no surgical approach is recommended.
Single-stage Orbital Decompression, Strabismus and Eyelid Surgery in Moderate to Severe Thyroid Associated Orbitopathy
Published in Orbit, 2022
Francesco M. Quaranta-Leoni, Matteo Di Marino, Antonella Leonardi, Sara Verrilli, Raffaello Romeo
The mean amount of inferior rectus recession in patients of subgroup 1B was 5.75 ± 0.95 mm. Three patients of subgroup 1B had esotropia prior to primary surgery, in two cases unmodified following decompression but with increased abduction deficit in one eye. Three patients of subgroup 1A (15%) had new onset esotropia following decompression. Surgical correction was performed at a second stage with medial rectus recession (mean amount of recession 6.85 ± 0.90 mm). Two patients were submitted simultaneously to lateral rectus resection to obtain eye alignment and to avoid or reduce prisms for correction of residual horizontal diplopia. Eight patients of subgroup 1B out of 9 (88.9%) had orthophoria after the surgery with no report of diplopia in the primary and the reading position and binocular single vision field increased in all patients. Decrease in postoperative exophthalmos in patients of subgroup 1B was not significantly different (p > .05) as compared to patients of group 3 (staged muscle surgery following orbital decompression). None of the patients of group 1 had further surgery to correct eyelid position. Two patients submitted to upper lid blepharotomy had a flat upper lid contour but refused further treatment. All patients graded the outcome as satisfactory to very satisfactory (Figure 2).
The efficacy of bupivacaine for the treatment of strabismus
Published in Strabismus, 2022
Martha Farrelly-Waters, Joe Smith, Krishan Parmar
Miller and colleagues14 reported that their participants’ injected muscle volumes increased by 6.6% and the maximum cross-sectional area had increased by 8.5% six months postinjection, gradually reducing thereafter from 53 to 253 days. They also noted that despite the reduction in both measurements, the change in ocular alignment continued to show improvements, with one patient demonstrating an esodeviation of 6.8 degrees reducing to orthophoria 253 days postinjection, despite the muscle size relaxing to the near normal. Karaca18 also documented a mean muscle volume of 821 mmÑ preinjection that increased to 1020 mmÑ at 3 months and reduced to 989 mmÑ at 12 months. Similarly, the mean cross-sectional muscle area increased from 7.4 cm2 to 8.5 cm2 by month 3 and reduced to 8.4 cm2 at 12 months. Furthermore, Scott et al.15 reported an average of 6.2% increase in the volume of the lateral rectus, with a range of −1.5% to 13.3% volumetric increase. The authors stated that the injected muscle reached its maximum volumetric increase around 60 days after injection; this then declined slightly but was maintained from 76 to 540 days postinjection.
Eccentric Gaze as a Possible Cause of “Zoom Fatigue”
Published in Journal of Binocular Vision and Ocular Motility, 2021
Another possible ramification of this study relates to outcomes for strabismus surgery. Historically, depending on the study, it has been assumed that an alignment of up to 10∆ or 15∆ from orthophoria, represents a satisfactory cosmetic outcome after strabismus surgery.10 These numbers have never been tested for validity. Although ocular dominance and its contribution to the mechanisms of human eye contact were not evaluated in this study, Babar and coauthors observed that patients with very small angle strabismus, far less than 10∆, perceive it as resulting in a lack of direct eye contact.11 This present study suggests that many untrained observers are sufficiently sensitive to detect positions of horizontal eccentric gaze as small as 0.9 degrees. Horizontal sidegaze eccentricity as created in this study is not the same as a residual strabismus of the same amount. With strabismus, the fixing eye would still be looking at the fixation object and only one eye is deviated. In the model used herein, both eyes are gazing eccentrically. Consequently, one should not make direct comparisons from the results of this study to the perception of small angles of strabismus in patients with residual strabismus.