Strabismus最新文献

{"title":"Double extraocular muscle avulsion following injury by goat's horn.","authors":"Bhavika Bansal, Shailja Tibrewal, Soveeta Rath, Richa Sharma, Suma Ganesh","doi":"10.1080/09273972.2025.2454480","DOIUrl":"https://doi.org/10.1080/09273972.2025.2454480","url":null,"abstract":"<p><p><i>Introduction</i>: Trauma to extraocular muscle without globe perforation is rare. This case report describes the clinical features and principles of repair of the simultaneous injury to two extraocular muscles sustained from a goat's horn. <i>Methods</i>: Case records of the 36-year-old man who suffered trauma to his left eye were reviewed. <i>Results</i>: Examination revealed diplopia, hypotropia of the left eye, and a lacerated superior conjunctiva through which a muscle tendon prolapsed. Magnetic resonance imaging (MRI) of the orbit indicated discontinuity and fuzziness of the left superior rectus muscle (SR). Surgical exploration showed that the prolapsed tendon belonged to the superior oblique muscle (SO). Avulsion of SR was also noted 14 mm from its insertion. The proximal end of SR was anastomosed with the distal segment. The proximal end of the SO could not be traced. Postoperatively, the elevation improved marginally and there was a small hypotropia. His diplopia was managed with prisms. <i>Discussion</i>:The goat's horn acted like a hook and avulsed two contiguous muscles from orbit in a posterior to anterior direction. The hypertropia due to SO avulsion was compensated partly by the hypotropia due to the concurrent damage to the SR. Immediate surgical intervention resulted in a good alignment.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-5"},"PeriodicalIF":0.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054257","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":"Canine tooth syndrome after frontoethmoidal osteoma surgery: a case report.","authors":"Hajar Farvardin, Fatemeh Ebrahimi, Hadi Farvardin, Maryam Kherad, Majid Farvardin","doi":"10.1080/09273972.2025.2457358","DOIUrl":"https://doi.org/10.1080/09273972.2025.2457358","url":null,"abstract":"<p><p><i>Introduction</i>: Canine tooth syndrome is a rare condition defined by the simultaneous presence of superior oblique palsy and Brown syndrome, resulting from pathological changes in the trochlear region. This syndrome can develop through various mechanisms, including dog bites, head trauma, infections, inflammation, and scarring. This report highlights its occurrence following sinus surgery for the first time. <i>Method</i>s: Medical and surgical records of an 18-year-old girl who presented with reading position diplopia after sinus surgery for right-side frontoethmoidal osteoma were retrospectively reviewed. <i>Results</i>: Strabismus examination revealed 8 Prism Diopter (PD) primary position hypertropia in the right eye that increased to 20 PD in downgaze. In the upward gaze to the left, the right eye showed 12 PD hypotropia with a positive forced duction test. The patient exhibited simultaneous signs of paresis and restriction of the right superior oblique muscle, consistent with type 7 of the Knapp classification. The patient declined strabismus surgery, and vertical diplopia was managed with prism spectacles. Long-term follow-up showed spontaneous resolution of superior oblique paresis leaving the patient with isolated Brown syndrome in the right eye. <i>Discussion</i>: Canine tooth syndrome can arise as a complication of frontoethmoidal sinus surgery due to excessive intraoperative manipulation of the superior and medial orbital wall, particularly in the trochlear region.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-5"},"PeriodicalIF":0.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034902","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":"Is inferior oblique botulinum toxin injection an effective surgical simulator prior to inferior oblique myectomy? A 30-year retrospective review.","authors":"Christopher Norbury, Haider Shah, Ian Marsh","doi":"10.1080/09273972.2025.2452623","DOIUrl":"https://doi.org/10.1080/09273972.2025.2452623","url":null,"abstract":"<p><p><i>Purpose:</i> Botulinum toxin A (BTX) injected into the inferior oblique muscle temporarily simulates the post-operative effect of an inferior oblique myectomy (IOM). This can aid in surgical planning, especially given the irreversible nature of IOM. This study evaluates the efficacy of BTX as a pre-operative simulator and compares its effects to those of IOM. To our knowledge, this is the largest reported series of patients undergoing pre-operative BTX simulations, prior to IOM.</p><p><p><i>Methods</i>: A retrospective review was conducted on all patients receiving inferior oblique BTX between 1 January 1994 and 1 January 2024, by a single surgeon using an electromyography-guided technique. Data, including diagnosis, procedure, and orthoptic measurements, were obtained from electronic and archived paper records. Successful outcome was defined as subjective improvement in symptoms, or objectively as, reduction of vertical angle deviation in primary position by at least 50%, or post-procedure vertical deviation in primary position of ≤5 Prism Dioptres (PD).</p><p><p><i>Results</i>: Sixty-eight patients underwent inferior oblique BTX within the study period. Of these, 48/68 patients (71%) had an improvement in subjective symptoms. Subsequently, 36/48 patients (78%) underwent IOM, 4/48 (8%) patients are awaiting IOM, 4/48 (8%) patients requested repeat BTX despite IOM being offered, and 4/48 (8%) patients had complete resolution with no further intervention. Following IOM, 34/36 (94%) achieved the defined successful outcome, with no significant difference between vertical deviation measurements following BTX or IOM (<i>p</i> < .05). No post-operative diplopia or other complications were identified, and 3/36 (8%) patients demonstrated an asymptomatic over-correction. BTX was deemed unsuccessful in 20 patients (29%). Within this cohort, 12 had no improvement (despite repeat treatment with a higher dose), 3 patients were lost to follow-up, 1 patient died and 4 patients developed problematic diplopia in the primary position, which resolved when the BTX wore off.</p><p><p><i>Conclusions</i>: Inferior oblique BTX is a useful and reliable tool for IOM simulation, prior to irreversible surgery. Its temporary effect on vertical deviation in primary position is comparable to IOM, and can also be used as a tool to identify patients at risk of diplopia, or failure of treatment.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034903","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":"Lateral rectus superior plication using non-absorbable sutures for adult onset esotropia.","authors":"Idan Hecht, Sigal Zmujack-Yehiam, Eran Pras, Adi Einan-Lifshitz, Nir Erdinest, Yair Morad","doi":"10.1080/09273972.2025.2454451","DOIUrl":"https://doi.org/10.1080/09273972.2025.2454451","url":null,"abstract":"<p><p><i>Introduction</i>: divergence insufficiency esotropia is a common cause for acquired esotropia and diplopia in adults. We present a novel procedure, superior plication of the lateral rectus using non-absorbable sutures, to address this condition and analyze the surgical outcomes. <i>Methods</i>: This is a retrospective cohort analysis. Adult patients operated on by a single surgeon for adult-onset esotropia between 1/2022 and 6/2023 were included. Demographic and medical histories, as well as measurements of deviation preoperatively and postoperatively were extracted and compared. Intraoperative and postoperative complications were noted. <i>Results</i>: Included were 15 patients with a mean age of 51.1 ± 12.6 years, 67% were female and 67% were myopic. All underwent normal neuroimaging and negative myasthenia work up, and all reported diplopia. On last postoperative follow-up (mean 9.1 ± 6.1 months) only one case had manifest deviation. Overall mean distance deviation decreased from 25.7 ± 11 prism diopters (PD) to 0.16 ± 0.8 PD (<i>p</i> < .001) and near from 19.4 ± 16 PD to 0 ± 0 PD (<i>p</i> < .001). No patients had diplopia or required prisms postoperatively. Suture extrusion was documented in two cases, and one case of pyogenic granuloma was noted and was responsive to topical therapy. <i>Discussion</i>: This study presents a novel surgical procedure for the treatment of adult-onset esotropia. Among consecutive cases operated using the technique, one patient had mild esotropia on follow-up and no patients had diplopia. Minimal postoperative complications were noted, with suture extrusion being the most common. Superior lateral rectus plication appears to be a safe and reliable option for the treatment of adult-onset esotropia.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-5"},"PeriodicalIF":0.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016174","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":"Exploring reduction of prolonged binocular vision testing time: the agreement between the first and second thirty seconds within one minute of accommodative and vergence facility tests.","authors":"Charles Darko-Takyi, Sandra Owusu, Emmanuel K Abu, Carl H Abraham, Michael Ntodie, Ebenezer Manu, Kumi O Boakye, Victoria Yirrah, Emmanuel Essien, Kwame O Osei, Stephen Ocansey","doi":"10.1080/09273972.2024.2449178","DOIUrl":"https://doi.org/10.1080/09273972.2024.2449178","url":null,"abstract":"<p><p><i>Purpose:</i> The study sought to compare the number of cycles (NOS) for the first and second thirty-seconds (FASTS) within 1 min of accommodative facility (AF) and vergence facility (VF) testing to explore possibilities of reducing testing time to 30 s. <i>Methods:</i> In this cross-sectional study, a multistage sample of school children (aged 8-17 years) was taken through ocular-visual screening. Eligible participants (586) underwent refraction, stereo-acuity measurement, AF testing using ± 2D lens flippers, and VF testing using 3^Δ BI/12^Δ BO flipper prisms. The NOS within the FASTS of AF and VF tests were compared, respectively. <i>Results:</i> A statistically insignificant mean difference of 0.01 cycles was found between the NOS for the FASTS of monocular AF in the right eye (Wilcoxon Signed Rank test, <i>p</i> = .715). Statistically significant differences of 0.06, 0.14, and 0.09 cycles (Wilcoxon Signed Rank test, <i>p</i> < .05) which are not clinically meaningful were found for monocular AF in the left eye, binocular AF, and VF with no level of agreement on Bland Altman analysis, respectively. There were no clinically meaningful differences between the first 30-s cycles multiplied by two (FTSMT) and the full 1-min test period cycles for monocular AF, binocular AF, and VF. <i>Conclusion:</i> The FTSMT approach may be applied during gross screening to shorten testing time as further study is recommended for its diagnostic validity.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-8"},"PeriodicalIF":0.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958585","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":"Surgical outcomes and etiological considerations in intermittent exotropia: a systematic narrative review.","authors":"Bernat Sunyer-Grau, Lluïsa Quevedo, Manuel Rodríguez-Vallejo, Marc Argilés","doi":"10.1080/09273972.2024.2449563","DOIUrl":"https://doi.org/10.1080/09273972.2024.2449563","url":null,"abstract":"<p><p><i>Introduction</i>: Is Intermittent Exotropia being conceived and treated as an ocular-mechanical problem? Is etiology taken into account when planning for intervention? Which success criteria are used? Are they based on alignment or do they also consider visual function? In order to answer these questions, a review of studies assessing the outcomes of strabismus surgery in Intermittent Exotropia has been conducted. <i>Methods</i>: published between January 2003 and December 2023 were included. The database searched was MEDLINE following a predefined protocol. In addition to electronic database searches, manual searches were carried out and experts contacted. A total of 102 studies comprising 12 974 participants were included in this review. <i>Results</i>: Possible strabismus etiology was not stated in 91.2% of the studies. The underlying causes of the deviation were not taken into account for treatment consideration in any of the studies. Criteria for surgical success was based solely on ocular alignment (82.4%) and only 10 studies (9.8%) defined successful surgery with both motor and sensory criteria. Thirty-four different definitions of successful ocular alignment were identified. <i>Discussion</i>: In conclusion, Intermittent exotropia etiology is omitted in studies assessing surgical outcomes. The possible causes of the deviation are not taken into account when deciding on the type of surgery and are rarely mentioned. In most studies, the criteria for surgical success is based solely on eye alignment, independently of visual function and control.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-11"},"PeriodicalIF":0.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958605","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":"Aberrant regeneration of third nerve combined with sixth nerve palsy in the setting of trauma: surgical results.","authors":"Savleen Kaur, Meghana G S, Claudia Raquel Polo, Jaspreet Sukhija","doi":"10.1080/09273972.2024.2447741","DOIUrl":"https://doi.org/10.1080/09273972.2024.2447741","url":null,"abstract":"<p><p><i>Introduction</i>: Aberrant regeneration of the third nerve is a known entity after trauma. It is important to recognize signs of aberrant regeneration and keep lid aperture disparity in mind before choosing the surgical procedure in such cases. Surgical procedure in these cases is often customized on case-to-case basis. <i>Methods</i>: Two cases with combined third and sixth nerve palsy are described. Both the patients had synergistic adduction on elevation and were treated by a single muscle transposition. <i>Results</i>: Both patients were orthotropic in the primary position with no diplopia and a reduction in synergistic adduction. <i>Conclusion</i>: Muscle transfer in the direction of aberrant movement works reasonably well in cases of partially recovered combined palsies. We present two cases detailing the usefulness of single muscle transposition, confirming the utility of this surgical technique in cases of aberrant regeneration.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-5"},"PeriodicalIF":0.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924108","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":"Analysis of retinal nerve fiber layer and macular thickness in amblyopic children treated with occlusion therapy.","authors":"Richa Agarwal, Rupak Brahma Choudhury, Prolima Thacker, Yashpal Goel, Kamlesh Kumar, Mohit Agarwal, Amr K Hassan, Hashem Abu Serhan","doi":"10.1080/09273972.2024.2444264","DOIUrl":"https://doi.org/10.1080/09273972.2024.2444264","url":null,"abstract":"<p><p><i>Purpose</i>: To study and evaluate the change in retinal nerve fiber layer (RNFL) and macular thickness and its clinical correlation with visual outcome following amblyopia therapy. <i>Methods</i>: In this prospective interventional study, children with moderate to severe amblyopia were given optical correction and part-time occlusion therapy. Visual assessment and optical coherence tomography (OCT) were performed at days 0 and 3, 6 months of follow-up. <i>Results</i>: A total of 30 children aged from 5 to 12 years with a mean age of 5.26 ± 1.65 years with moderate to severe amblyopia were included. About 19 patients (63.33%) were males and 11 patients (36.66%) were females. Anisometropia was the most common cause of amblyopia in our study population affecting 46.67% of patients. The mean global RNFL thickness in amblyopic eyes before and after patch therapy were 111.13 um and 104.96 um respectively (6.17 um thinner than better eyes). The macular thickness before and after patch therapy was 227.06 um and 226.80 um respectively (0.26 um thinner than better eyes). <i>Conclusions</i>: Part-time occlusion therapy results in visual gain in children with moderate to severe amblyopia. However, it causes thinning in both the RNFL and macular thickness at days 0 and 3, 6 months of follow-up.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900103","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":"Occlusion with high plus contact lenses in the treatment of strabismic amblyopia - a case series.","authors":"Ulrike Pichler, Lisa Gabriela Schneebauer, Verena Schoßleitner, Matthias Bolz, Anna Reisinger","doi":"10.1080/09273972.2024.2437411","DOIUrl":"https://doi.org/10.1080/09273972.2024.2437411","url":null,"abstract":"<p><p><i>Introduction</i>: Amblyopia is a common disease, and interventions like patching treatment are well studied. When standard therapy fails, sometimes uncommon treatment options become necessary. <i>Methods</i>: We present three cases of patients with severe strabismic amblyopia with initial visual acuities of 20/400, 20/2000 and 20/160 who failed conventional treatment and subsequently received treatment with high-powered contact lenses (HPCL) of either + 22D or + 25D strength. <i>Results</i>: Visual acuity markedly improved in all three cases: 20/20, 20/50 and 20/25, respectively. <i>Conclusion</i>: While amblyopia treatment with HPCL will never be first-line therapy, our results are encouraging and show that this form of penalization should be considered if conventional therapy fails.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-4"},"PeriodicalIF":0.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814878","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":"The role of stereopsis in microsurgical performance on the EYESi ophthalmic surgical simulator.","authors":"Hanouf Alkharashi, Robert LaRoche, Leah Walsh, David Westwood","doi":"10.1080/09273972.2024.2433962","DOIUrl":"https://doi.org/10.1080/09273972.2024.2433962","url":null,"abstract":"<p><p><i>Introduction</i>: There remains a lack of compelling objective evidence on whether stereopsis is necessary for an ophthalmic surgical career. It is also unclear if high-grade stereoacuity correlates with better surgical performance. The present study attempts to address this question by comparing the simulated surgical performance of subjects with different levels of stereoacuity using a virtual reality (VR) intraocular surgical simulator (EYESi, VRmagic, Mannheim, Germany). <i>Methods</i>: Subjects were tested based on their stereoacuity level and stratified in three age-matched groups: normal stereopsis, subnormal stereopsis, and patients with no measurable stereoacuity in the clinical setting. Eleven subjects in each group to make a total of 33 subjects with no prior surgical experience were recruited from the IWK Health Centre, Halifax, Canada (REB trial registration: 1023183). Subjects performed three attempts on a standardized microsurgical module on the EYESi VR simulator. <i>Results</i>: There was no significant main effect of the stereo-group that the participants belonged to on their total scores, or on the time needed to complete the task, or on the odometer value, or on the amount of injury to surrounding tissues. <i>Discussion</i>: This study showed that for a basic simulated microsurgical task on the EYESI intraocular surgical simulator, the performance of individuals with reduced and absent stereoacuity was statistically indistinguishable from those with normal stereoacuity. Therefore, caution is still recommended when advocating for mandatory high level of stereoacuity as a requirement for admission to training programs in ophthalmology. There is still definite need for solid evidence that stereopsis is necessary to achieve satisfactory skills in ophthalmic microsurgery.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-10"},"PeriodicalIF":0.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774425","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}