Top-Ten-Must-Not-Forget-In-Strabismus-Evaluation
1. External face features affecting the eye position Facial asymmetry and palpebral fissure shape changes alter the ocular position, possibly due to extra-ocular muscle heterotopy The common extra-ocular features affecting ocular position are craniosynostosis, hydrocephalus, facial fracture, mongoloid and anti-mongoloid slant, telecanthus, congenital superior oblique palsy (face fuller on the affe...Read More
How to examine a case of strabismus ?
There is no substitute to good history obtained at the start of the examination As history gives us a direction to look for, and find pertinent signs aiding in diagnosis and management. The various presenting complaints could range from abnormal head posture, deviation noticed by parents or friends, intermittent eye closure, double vision and so on. Some important points to be noted in patients wi...Read More
Diplopia Charting Diplopia chart is the record of separation of the diplopic or double images in the nine positions of gaze. It can be plotted charted in patients who cooperate and can appreciate the double vision and with incomitant or comitant deviation. The method The patient should be comfortable with his head erect and should preferably be still throughout the examination. The test is prefera...Read More
Fun with Prisms in Ophthalmology
What are prisms? Prisms are nothing but a portion of a refracting medium bordered by two plane surfaces that are inclined at a finite angle. Prisms have a thicker portion called the base of the prism and a tapering portion called the apex of the prism. Prisms are oriented with their apex towards the direction of deviation. What happens to light when it enters a prism? Light has particle and wave c...Read More
Ten Pearls in the Management of Paralytic Strabismus
Paralytic strabismus is an incomitant strabismus resulting from complete (paralysis) or partial (paresis) motor deficiency of one or a group of extraocular muscles, which are supplied by the third, fourth or sixth cranial nerve. 1 History and basic examination Paralytic strabismus may be congenital or acquired. Careful history-taking will rule out an antecedent fever, trauma, neurological symptoms...Read More
Duanes Retraction Syndrome Made Ridiculously Simple
Synonyms: Stilling–Turk–Duane syndrome. Duane Retraction Syndrome is a type of congenital cranial dysinnervation which occurs in 1-4% of strabismus cases. It has varied presentation mostly involving variable horizontal duction deficits, with narrowing of the palpebral fissure and globe retraction on attempted adduction, occasionally accompanied by upshoot or down shoots Etiopathogenesis Various th...Read More
Esotropia Made Simple for the Postgraduates
As like other strabismus, esodeviation can be, True esodeviation Pseudo esodeviation A prominent epicanthic folds 1, 2 Negative angle kappa in high myopes. True esodeviation can be either comitant or incomitant 1,2 A. Comitant I. Accommodative esotropia. Refractive accommodative esotropia (normal AC/A ratio) Non Refractive accommodative esotropia (high AC/A ratio) Hypo accommodative esotropia (red...Read More
Ten Tips for Management of Nystagmus
Nystagmus is defined as an involuntary rhythmic oscillation of one or both the eyes. Clinical assessment and eye movement recordings are important to diagnose and classify nystagmus. It is essential to have patience while examining a child, as anxiety often increases nystagmus. 1.Classification Physiological eye movements have to be differentiated from pathological eye movements. The older etiolog...Read More
Ten Commandments in Squint Workup for Postgraduates
Squint is the Ocular Imbalance in which visual axes of both eyes do not meet at the point of regard. It can be regarded as a form of One Eye Blindness since both eyes are not seeing simultaneously, with a squinting eye being suppressed. Hence strabismus must be treated with due care. Squint evaluation can be simplified by the following checklist. Every squint patient must undergo this checklist of...Read More
