PURPOSE To study whether the variation in maximum oblique muscle size accounts for individual variation in the Bielschowsky head tilt phenomenon (BHTP) in clinically diagnosed superior oblique (SO) palsy. METHODS Seventeen subjects with clinically diagnosed early-onset or idiopathic SO palsy and 14 normal subjects were enrolled in the study. Magnetic resonance imaging (MRI) in coronal and sag...

BACKGROUND Several inferior oblique (IO) weakening methods exist for correction of superior oblique palsy (SOP). A previously reported method involved recession and anteriorization according to IO overaction (IOOA) grade, which might be subjective and cause upgaze limitation and opposite vertical strabismus. Therefore, this study attempted to examine the efficacy of modified graded recession an...

Cathodal galvanic currents activate primary vestibular afferents, whereas anodal currents inhibit them. Pulsed galvanic vestibular stimulation (GVS) was used to determine the latency and initiation of the human vestibuloocular reflex. Three-dimensional galvanic vestibuloocular reflex (g-VOR) was recorded with binocular dual-search coils in response to a bilateral bipolar 100-ms rectangular puls...

PURPOSE To study size and contractility of the normal inferior oblique (IO) muscle using high-resolution magnetic resonance imaging (MRI) and to evaluate abnormalities of the superior oblique (SO) and IO muscles in chronic SO palsy. DESIGN Prospective, case control study. PARTICIPANTS Thirteen patients with SO palsy and 17 orthotropic subjects. METHODS High-resolution, surface coil MRI wa...

IMPORTANCE Recognition of sagging eye syndrome (SES) as the cause of chronic or acute acquired diplopia may avert neurologic evaluation and imaging in most cases. OBJECTIVES To determine whether SES results from inferior shift of lateral rectus (LR) extraocular muscle (EOM) pulleys and to investigate anatomic correlates of strabismus in SES. DESIGN AND SETTING We used magnetic resonance ima...

S kew means set, placed, or running obliquely; slanting. For a century, skew deviation has been the descriptive term for an acquired vertical deviation that slants the interpupillary axis to an oblique orientation. 3 This condition has traditionally connoted a severe and debilitating neurological injury within the posterior fossa. Subsequent investigation has refined our understanding of this d...

We report 3 patients with acquired nystagmus who were treated with eye muscle tenotomy and reat­ tachment. The first patient had acquired pendular nystagmus (APN) associated with multiple sclerosis (MS) and underwent bilateral medial rectus tenoto­ mies and bilateral lateral rectus recessions to cor­ rect exotropia. Eye movements were recorded before surgery, after surgery, and after surgery an...

A 1-month old female Holstein calf had not been able to stand since birth. Delivery was uncomplicated and no treatment had been administered before admission. On physical examination, the calf had slightly decreased body condition, but was bright and alert. The calf was in lateral recumbency with spastic extension of all four limbs and opisthotonus. If positioned in left lateral recumbency, the...

At our institution ophthalmology, neuro-ophthalmology, neurology, and gastroenterology consults were initiated. A radionucleotide gastric emptying study confirmed complete immotility. Evaluation of diplopia with prism testing revealed fluctuating levels of exotropia and hypertropia in the left eye. CT of the chest, abdomen, and pelvis revealed a 6 ! 6 ! 3 cm anterior mediastinal mass which was ...

Examination of the pupillary response to light and accommodation can provide precise information concerning the localization of a lesion within the sympathetic and parasympathetic pathways, the anterior visual pathway, or the brainstem (Table 1). Classical teaching has associated all lesions of the rostral midbrain with bilateral lightnear dissociation (LND), defined as attenuation of the pupil...