INTRODUCTION Inferior oblique overaction (IOOA) can be primary or secondary, isolated or combined to other types of horizontal deviation, mostly with esotropias. Surgical weakening of IOOA means several techniques like; recession, myotomy, myectomy, anteroposition etc. GOALS we analyzed the effect of inferior oblique muscle surgical weakening comparing two groups of patients with primary hype...

OBJECTIVE To determine whether congenital fibrosis of the extraocular muscles (CFEOM) with Marcus Gunn jaw-winking phenomenon (MG) can result from mutations in the KIF21A gene encoding a kinesin motor protein. METHODS An individual with CFEOM1 (classic autosomal dominant CFEOM) and MG underwent a comprehensive ophthalmic examination. He and his healthy parents underwent screening for mutation...

PURPOSE To report an effect of the full tendon transposition augmented with posterior intermuscular suture and recession-resection surgery, for the patient with monocular elevation deficiency (MED) and large exotropia. METHODS Interventional case report. Full tendon transposition augmented with posterior intermuscular suture and recession-resection surgery was performed for a 26-year-old male...

PURPOSE We wanted to examine the effect of graded recession and anteriorization of the inferior oblique muscle on patients suffering from unilateral superior oblique palsy. METHODS Inferior oblique muscle graded recession and anteriorization were performed on twenty-two patients (22 eyes) with unilateral superior oblique palsy. The recession and anteriorization were matched to the degree of i...

We have made intraoperative, continuous-registration, length-tension diagrams of detached eye muscles in 80 strabismus patients under general anaesthesia. In 47 of these we repeated the measurements after contraction evoked by succinylcholine chloride. In contracting horizontal and vertical rectus muscles, we found a linear relation between length and tension. In contracting oblique muscles, ho...

PURPOSE To introduce Hess Lancaster screen test performed with the head tilted as a new ancillary test to help in the diagnosis of bilateral superior oblique (SO) nerve paresis. METHODS Three patients with clinical diagnosis of acquired bilateral fourth nerve paresis, three with clinical diagnosis of acquired unilateral fourth nerve paresis, and three normal subjects were tested with Hess Lan...

PURPOSE To evaluate the effect of deep lateral wall orbital decompression with intraconal fat debulking on strabismus in thyroid-related orbitopathy (TRO) patients using automated Hess screen (AHS). DESIGN Prospective nonrandomized clinical study. PARTICIPANTS Eleven TRO patients (19 surgeries) operated on at the Jules Stein Eye Institute from January, 2004, through December, 2004. METHOD...

PURPOSE Exotropia in congenital homonymous hemianopia has been reported to provide field expansion that is more useful when accompanied with harmonious anomalous retinal correspondence (HARC). Torsional strabismus with HARC provides a similar functional advantage. In a subject with hemianopia demonstrating a field expansion consistent with torsion, we documented torsional strabismus and torsion...

Type II Duane’s retraction syndrome (DRS) is the least common strabismus characterized by limitation of adduction with the presence of upshoot, downshoot or both. Abduction can be normal or slightly altered. Secondary muscle changes like fibrosis, and anomalous insertions have been associated with DRS. Its associations with dissociated vertical deviations have been reported. We report a rare ca...

A 43-year-old Caucasian man developed persistent nystagmus after 10 months of weight loss, diarrhea, insomnia, and 5 months of agitation, memory impairment, and vision changes consisting of nystagmus and double vision. Ocular motor examination demonstrated left-beating nystagmus (LBN), upbeating nystagmus (UBN), and torsional (toward the left ear) nystagmus components (video at Neurology.org/ n...