{"title":"Different Laterality in Hereditary Monozygotic Twins with Duane Retraction Syndrome Type I: A Case Report.","authors":"Reza Jafari, Anousheh Ghaffari, Alireza Razavi, Zahra Heidari","doi":"10.1080/2576117X.2026.2640745","DOIUrl":"https://doi.org/10.1080/2576117X.2026.2640745","url":null,"abstract":"<p><strong>Background: </strong>Simultaneous contraction of the medial and lateral rectus muscles results in Duane Retraction Syndrome (DRS). The presence of a familial pattern in some cases suggests an autosomal dominant mode of transmission. Despite the variable presentation of this syndrome, its cause remains unclear. Describing the potential factors contributing to DRS in monozygotic twins may be effective in explaining its etiology.</p><p><strong>Case presentation: </strong>We report a unique case of monoamniotic monozygotic twins case both 7-year-old Iranian girls with DRS type I, inherited from their 36-year-old father with DRS type III. There was no clinical manifestation of DRS in the 38-year-old Iranian mother. One twin exhibited bilateral DRS, whereas the other manifested DRS exclusively in the right eye. In contrast, their father had DRS limited to the left eye. The unique laterality discordance in monozygotic twins emphasizes the role of gene expression patterns in the variability of DRS. These findings highlight the complex nature of clinical expression of DRS. Furthermore, we recognize the need to consider additional factors, such as placental dynamics, the environment, epigenetic modifications, and vascular development, for a comprehensive understanding of this condition.</p><p><strong>Conclusion: </strong>While genetic factors may play a fundamental role in understanding DRS in twins, it is important to consider the interaction of placental, environmental, epigenetic, and vascular developmental factors for a comprehensive approach.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kai Xu, Yidan Zhang, Wangyi Fang, Qingyu Liu, Zian Hu, Wen Li, Kourosh Shahraki, Donny W Suh, Tong Qiao
{"title":"Clinical Characteristics and Surgical Outcomes of Acute Acquired V-Pattern Esotropia: A Comparative Study Highlighting Novel Demographics, Refractive Profiles, and Superior Sensory Recovery.","authors":"Kai Xu, Yidan Zhang, Wangyi Fang, Qingyu Liu, Zian Hu, Wen Li, Kourosh Shahraki, Donny W Suh, Tong Qiao","doi":"10.1080/2576117X.2026.2638594","DOIUrl":"https://doi.org/10.1080/2576117X.2026.2638594","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the clinical profile, surgical outcomes, and prognostic factors of acute acquired V-pattern esotropia (AAVE), a rare, understudied subtype of strabismus, and compare its features to classic V-pattern esotropia (VE).</p><p><strong>Methods: </strong>In this retrospective cohort study, 37 AAVE and 39 VE patients underwent standardized surgical correction. Outcomes included alignment, stereoacuity, and refractive status.</p><p><strong>Results: </strong>Compared to VE, AAVE patients were significantly older at onset (8.5 vs. 3.0 years, <i>p</i> < .0001), exhibited milder hyperopia (+0.68D vs. +2.90D, <i>p</i> < .0001), and presented with larger preoperative esodeviations (44.1 vs. 36.8 PD, <i>p</i> = .0109). After 1-year follow-up, stereoacuity recovery was superior in AAVE patients (80.8% achieving good stereoacuity vs. 37.9% in VE; <i>p</i> = .0127), though surgical success rates did not differ significantly (73.0% vs. 64.1%, <i>p</i> = .4057).</p><p><strong>Conclusion: </strong>AAVE represents a distinct diagnostic entity marked by acute onset, older age, and superior postoperative sensory recovery. Its unique refractive profile and association with modern near-work stressors raises consideration of modern visual stressors in pattern strabismus, supporting consideration of early surgical intervention to maximize binocular potential. These findings suggest that AAVE represents an important subtype in pediatric ophthalmology, supporting the need for updated clinical guidelines.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical Profile and Surgical Outcomes of Bilateral Duane Syndrome with Exotropia.","authors":"Adeline Shona Lasrado, Goura Chattannavar, Ramesh Kekunnaya","doi":"10.1080/2576117X.2026.2627033","DOIUrl":"https://doi.org/10.1080/2576117X.2026.2627033","url":null,"abstract":"<p><strong>Objective: </strong>To study the clinical profile and surgical outcomes of patients with bilateral Duane syndrome with exotropia.</p><p><strong>Methods: </strong>The records of all consecutive patients diagnosed with bilateral Duane syndrome with exotropia in primary gaze (2010-2024) were reviewed. Patient demography, age at presentation, and type of Duane syndrome were studied in the clinical profile. The pre-operative and post-operative details of angle of deviation, abnormal head posture, horizontal ocular ductions, grade of globe retraction, and overshoot were evaluated for the surgical outcomes.</p><p><strong>Results: </strong>Forty-five patients (male, 51%) were diagnosed with bilateral Duane syndrome with exotropia, of which 38% underwent surgical correction. The mean age at presentation was 18.06 ± 12.08 years. Of the total, 37% were emmetropic and 29% amblyopic. Bilateral type 3 Duane syndrome (49%) was the most common presentation. The mean pre-operative deviation for distance and near was 29.84 ± 17.73Δ and 32.49 ± 18.44Δ, respectively. The mean change in angle of deviation post-operatively for distance and near was 23 ± 5Δ and 26 ± 5Δ, respectively. The average angle of deviation at the final follow-up for distance was 8 ± 12Δ and near 12 ± 12Δ. Surgical success for primary position deviation, abnormal head posture, globe retractions, and overshoots was achieved in 59%, 86%, 57%, and 50% patients, respectively.</p><p><strong>Conclusion: </strong>Bilateral type 3 is the most common bilateral Duane syndrome with exotropia. Individualized surgical management (algorithm) ensures optimal alignment and head posture correction.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":"76 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sepideh Tavakolizadeh, Mohammad Reza Akbari, Mehdi Khabazkhoob, Mohammad Mehrpour
{"title":"Divergence Insufficiency Esotropia Associated with Excessive Near Work During the Coronavirus Pandemic.","authors":"Sepideh Tavakolizadeh, Mohammad Reza Akbari, Mehdi Khabazkhoob, Mohammad Mehrpour","doi":"10.1080/2576117X.2026.2615499","DOIUrl":"10.1080/2576117X.2026.2615499","url":null,"abstract":"<p><strong>Purpose: </strong>The COVID-19 lockdown has had a profound impact on people's lifestyles - especially the youth - through school closures and home confinement. Accordingly, the excessive use of smartphones and digital devices made adolescents vulnerable to the adverse effects of excessive near work on the eyes.</p><p><strong>Method: </strong>Four adolescents (10-17 years) with acute acquired divergence insufficiency esotropia were evaluated.</p><p><strong>Results: </strong>The mean age of our patients was 14 years old (10-17). Their mean deviation at distance was 32.5 PD (25-40 PD), and their mean near deviation was 13 PD (8-20 PD). All patients had normal neurological examinations and exhibited normal brain and orbital MRI results. Excessive near work with digital devices such as smartphones after the COVID-19 lockdown was the only risk factor identified. All cases were successfully treated with bilateral lateral rectus resection. A 3.5- to 5.5-mm bilateral lateral rectus resection corrected 25 to 40 PD esotropia at distance without overcorrection at near.</p><p><strong>Conclusion: </strong>Decreased outdoor activities and excessive near work during the COVID-19 pandemic could be associated with divergence insufficiency esotropia in adolescents. Bilateral lateral rectus resection is an acceptable surgical treatment.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"10-15"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brandon Francis, Michelle Go, Stacy L Pineles, Federico G Velez
{"title":"Selective Nasal Anterior Superior Oblique Tenectomy for the Treatment of Superior Oblique Myokymia.","authors":"Brandon Francis, Michelle Go, Stacy L Pineles, Federico G Velez","doi":"10.1080/2576117X.2026.2636321","DOIUrl":"10.1080/2576117X.2026.2636321","url":null,"abstract":"<p><p>Superior oblique myokymia is a rare condition characterized by spontaneous episodes of high frequency, low amplitude, usually unilateral torsional oscillopsia. Surgical treatment is indicated when medical therapy fails to improve symptoms. The traditional surgical recommendation is an ipsilateral full-tendon superior oblique tenectomy to remove all attachments of the superior oblique tendon to the sclera. This approach will likely result in a secondary superior oblique palsy, requiring simultaneous weakening of the ipsilateral inferior oblique muscle. We report a patient presenting with diplopia and oscillopsia in the setting of superior oblique paresis and myokymia with persistent symptoms after initial superior oblique tuck. An alternative surgical approach consisting of superior oblique anterior one-third nasal tenectomy and contralateral inferior rectus recession resulted in marked improvement of oscillopsia associated with superior oblique myokymia while minimizing the risk of inducing downgaze diplopia often observed with superior oblique tenectomy.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"16-18"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Congenital Optic Disc Anomalies-A Picture is Worth a Thousand Words!","authors":"Robert E Wiggins","doi":"10.1080/2576117X.2025.2575553","DOIUrl":"https://doi.org/10.1080/2576117X.2025.2575553","url":null,"abstract":"<p><p>Congenital optic disc anomalies are uncommon causes of vision loss that may be recognized shortly after birth but may also be identified in later childhood and sometimes well until adulthood. They may be unilateral or bilateral and isolated or associated with other systemic findings. In some conditions the origin of the developmental abnormality is understood as in the case of optic disc colobomas resulting from failure of closure of the embryonic fissure whereas in others the cause is hypothetical. Recognition of these anomalies is usually by direct observation though ancillary testing may aid in the diagnosis. Understanding the spectrum of congenital optic disc anomalies can help the clinician with diagnosis and treatment, counsel the patient and their family regarding prognosis, and to recognize when further evaluation is indicated.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":"75 4","pages":"108-116"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Under Pressure: Increased Intracranial Pressure in Infants and Children. Presented at the 2024 AOC/AACO/AAO Sunday Symposium.","authors":"Tiffany Yuen, Aarti Vyas, Sameea Tahir, Melinda Chang","doi":"10.1080/2576117X.2025.2548363","DOIUrl":"https://doi.org/10.1080/2576117X.2025.2548363","url":null,"abstract":"<p><p>Intracranial hypertension (ICH) in children refers to increased pressure within the skull. The skull normally contains the brain, blood vessels, meninges, and cerebrospinal fluid (CSF). Abnormalities in any of these intracranial structures may cause ICH. The differential diagnosis for pediatric ICH includes brain tumors; intracranial hemorrhages; intracranial infections; craniosynostosis; disorders of CSF production, clearance, or abnormal CSF contents; and pseudotumor cerebri syndrome (PTCS), which may be primary (also known as idiopathic intracranial hypertension [IIH]) or secondary. Children with suspected ICH should undergo a thorough history and examination, focused on determining whether the child has papilledema and/or abducens nerve palsy. The differential diagnosis of papilledema includes other causes of optic disc edema, such as optic neuritis, as well as pseudopapilledema. The differential diagnosis of abducens nerve palsy includes Duane syndrome and other causes of childhood esotropia. In children with suspected papilledema, ancillary ophthalmic testing including visual fields, optical coherence tomography (OCT), fundus photography, autofluorescence, fluorescein angiography, and ultrasonography may be indicated. The systemic workup for children with suspected ICH includes neuroimaging and lumbar puncture in certain cases. Management of children with ICH is focused on treating any underlying cause and lowering intracranial pressure with medications or surgery.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":"75 4","pages":"95-107"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hamidreza Hasani, Mohammad Ghorbani, Sima Sheikhghomi, Alireza Mahmoudi
{"title":"Traumatic Carotid-Cavernous Fistula in a Child with Nasal Penetrating Injury.","authors":"Hamidreza Hasani, Mohammad Ghorbani, Sima Sheikhghomi, Alireza Mahmoudi","doi":"10.1080/2576117X.2025.2594123","DOIUrl":"10.1080/2576117X.2025.2594123","url":null,"abstract":"<p><strong>Background: </strong>Traumatic penetrating carotid-cavernous fistula (CCF) is an uncommon complication of craniofacial trauma, particularly in pediatric patients. Prompt recognition is essential to prevent irreversible visual and neurological deficits.</p><p><strong>Case presentation: </strong>We describe a 2.5-year-old boy who sustained a penetrating nasal injury caused by a screwdriver. He initially presented with epistaxis and subsequently developed left-sided proptosis, chemosis, and restricted ocular motility. Early imaging studies were inconclusive, and orbital cellulitis was initially suspected.</p><p><strong>Diagnosis and management: </strong>A delayed diagnosis of a direct (Type A) CCF was ultimately confirmed using digital subtraction angiography (DSA). The patient underwent successful endovascular embolization combined with internal carotid artery (ICA) stenting.</p><p><strong>Conclusion: </strong>This case highlights the need for a high index of suspicion for CCF in children presenting with atypical orbital findings following facial trauma, even when initial imaging doesn't reveal definitive pathology.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"81-84"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reed M Jost, Kartik Kumar, Lori M Dao, Becky Luu, Anastasia A Alex, Brooke A Koritala, Christina Cheng-Patel, Krista R Kelly, Eileen E Birch
{"title":"Everyday Consequences of Childhood Intermittent Exotropia.","authors":"Reed M Jost, Kartik Kumar, Lori M Dao, Becky Luu, Anastasia A Alex, Brooke A Koritala, Christina Cheng-Patel, Krista R Kelly, Eileen E Birch","doi":"10.1080/2576117X.2025.2579357","DOIUrl":"10.1080/2576117X.2025.2579357","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of intermittent exotropia (IXT) on eye-related quality of life (ERQOL), reading speed, motor skills, and self-perception in children.</p><p><strong>Patients and methods: </strong>Fifty-one children with basic or pseudo divergence excess IXT (4-13y) were assessed with the triple office control score, a graded clinical measure of exotropia control. Children with IXT also completed at least one of four behavioral evaluations, including ERQOL (PedEyeQ), reading speed (Readalyzer), motor skills (Movement Assessment Battery for Children-2), and self-perception (Self-perception Profile for Children), along with visual acuity and stereoacuity. Results were compared to those of age-matched controls (<i>n</i> = 353) and associations with IXT control score were analyzed.</p><p><strong>Results: </strong>Children with IXT and their parent had significantly lower ERQOL scores in all domains compared to controls (Ps < .001). Reading speed was comparable to controls (<i>p</i> = .66). However, children with IXT showed poorer Manual Dexterity (Ps < .001) and Aiming and Catching motor skills (<i>p</i> = .009) in older children. Older children reported lower self-perception in Scholastic competence, Social competence, Athletic competence, and Physical appearance domains (Ps < .05). Worse IXT control scores were associated with lower self-perception of Cognitive/Scholastic competence and Maternal acceptance.</p><p><strong>Conclusion: </strong>Children with IXT experience reduced ERQOL, impaired motor skills, and lower self-perception. These findings highlight the broad developmental impact of IXT, beyond visual function.</p>","PeriodicalId":37288,"journal":{"name":"Journal of Binocular Vision and Ocular Motility","volume":" ","pages":"69-80"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}