Inferior rectus displacement in heavy eye syndrome and sagging eye syndrome

2020 ◽  
Vol 258 (5) ◽  
pp. 1109-1113 ◽  
Author(s):  
Michael Kinori ◽  
Megha Pansara ◽  
Derek D. Mai ◽  
Shira L. Robbins ◽  
John R. Hesselink ◽  
...  
Keyword(s):  
Inferior Rectus ◽  
Sagging Eye Syndrome

scholarly journals Incidence and Risk Factors of Inferior Rectus Muscle Palsy in Pediatric Orbital Blowout Fractures

2018 ◽  
Vol 11 (1) ◽  
pp. 028-034 ◽  
Author(s):  
Stephanie M. Young ◽  
Yan Tong Koh ◽  
Errol W. Chan ◽  
Shantha Amrith
Keyword(s):  
Risk Factors ◽  
Clinical Features ◽  
Pediatric Patients ◽  
Rectus Muscle ◽  
Orbital Floor ◽  
Case Review ◽  
Inferior Rectus ◽  
Retrospective Case ◽  
Orbital Blowout Fractures ◽  
Inferior Rectus Muscle

The aim of this study was to evaluate the incidence, clinical features, and risk factors of sustaining inferior rectus (IR) palsy in a group of pediatric patients with orbital floor blowout fractures. We performed a retrospective case review of sequential cases of pediatric orbital floor blowout fractures (<18 years old) from 2000 to 2013 in a tertiary ophthalmic center in Singapore. A total of 48 patients were included in our study, of whom 5 had IR palsy (10.4%). Patients with IR palsy had a higher mean age (16.4 ± 1.5 years) compared with patients without IR palsy (12.4 ± 3.3 years), had significantly ( p < 0.05) worse preoperative motility, and had significantly greater proportion developing postoperative hypertropia (100%) compared with patients without IR palsy (4.7%). Our series of pediatric blowout fractures demonstrated IR palsy prevalence and clinical features for IR palsy which may be distinct to the pediatric group.

Evaluation of extraocular muscles in patients with thyroid associated ophthalmopathy using apparent diffusion coefficient measured by magnetic resonance imaging before and after radiation therapy

2021 ◽  
pp. 028418512110340
Author(s):  
Wu Yu ◽  
Lao Zheng ◽  
Zhang Shuo ◽  
Liu Xingtong ◽  
Jiang Mengda ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Radiation Therapy ◽  
Apparent Diffusion Coefficient ◽  
Extraocular Muscles ◽  
Clinical Activity ◽  
Inferior Rectus ◽  
Thyroid Associated Ophthalmopathy ◽  
Before And After ◽  
Apparent Diffusion ◽  
The Mean

Background Thyroid-associated ophthalmopathy (TAO) is an autoimmune orbital disease characterized by edema of extraocular muscles (EOMs). Purpose To characterize the inflammation of EOMs in patients with TAO before and after radiation therapy using apparent diffusion coefficient (ADC) and to analyze the correlation between ADC and clinical activity of TAO. Material and Methods The ADCs of superior rectus (SR), inferior rectus (IR), medial rectus (MR), and lateral rectus (LR) muscles were measured in 52 eyes of 26 patients with TAO before and three months after orbital radiation therapy. In addition, 38 eyes of 20 healthy volunteers were included. The clinical activity score (CAS) was evaluated. The ADC maps were reconstructed and measured on the coronal diffusion-weighted imaging (DWI) sequence and calculated in mm2/s. Results The mean ADCs of EOMs before treatment were 1.42 ± 0.23 in SR, 1.37 ± 0.23 in IR, 1.41 ± 0.21 in MR, and 1.28 ± 0.25 in LR. The mean ADCs after treatment were 1.27 ± 0.18, 1.22 ± 0.26, 1.30 ± 0.22, and 1.15 ± 0.21, respectively. The ADCs were significantly decreased after treatment (all P < 0.001). The ADCs of patients with TAO were significantly higher than those of controls. There was a statistically significant correlation between the mean ADCs and the CAS in each patient with TAO both before and after treatment (before: r = 0.520; P < 0.001; after: r = 0.625; P < 0.001). Conclusion The ADC values of EOMs can be exploited as a quantitative indicator to evaluate the clinical activity and monitor the therapeutic responses of patients with TAO.

Features of surgical treatment of Brown's syndrome in children

2021 ◽  
pp. 11-16
Author(s):  
N.A. Malinovskaya ◽  
◽  
E.V. Semyonova ◽  
A. Toriya ◽  
P.A. Nikonorova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Binocular Vision ◽  
Rectus Muscle ◽  
Oblique Muscle ◽  
Double Vision ◽  
Inferior Rectus ◽  
Inferior Oblique Muscle ◽  
Straight Position ◽  
Third Stage

Purpose. To study the features of surgical treatment of Brown's syndrome in children. Material and methods. 47 children with Brown's syndrome aged from one to 10 years were treated: 4 children had bilateral form, 43 had congenital form and 4 had acquired form. The operation was performed for 44 children. The indications for surgical treatment were double vision in a straight position, forced position of the head, impaired binocular vision. Results. Three children with acquired Brown's syndrome had a positive effect on the background of conservative treatment. Surgical treatment of Brown's syndrome was effective, but often required repeated interventions (31 patients, 70%): the first stage was weakening of the superior oblique muscle (tenotomy, recession, prolongation), the second stage was recession of the inferior oblique muscle, the third stage was recession of the contralateral inferior rectus muscles (4 patients, 9%). In a number of cases (5 children, 11%), at the outcome of surgical treatment, asymmetry of the palpebral fissures was noted due to mild enophthalmos in the operated eye (the result of weakening of the oblique muscles that «pull» the eyes out of the orbit and weakening of the contralateral inferior rectus muscle that «tightens» the eyeball). Conclusion. Surgery for Brown's syndrome is effective, but often requires reoperation. With acquired forms of Brown's syndrome, examination and the first stage of conservative treatment are required. The absolute indications for surgical treatment of Brown's syndrome are forced head position, double vision in a straight position and impaired binocular vision. Keywords: Brown's syndrome, double vision in a straight position, forced position of the head, impaired binocular vision, surgical treatment.

Simulation of complex strabismus surgical procedures on goat eyes

2021 ◽  
pp. 112067212110451
Author(s):  
Amar Pujari ◽  
Vaishali Rakheja ◽  
Sujeeth Modaboyina ◽  
Deep Das ◽  
Manasi Tripathi ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Surgical Simulation ◽  
Muscle Length ◽  
Lateral Rectus ◽  
Muscle Quality ◽  
Oblique Muscle ◽  
Inferior Rectus ◽  
Superior Rectus ◽  
Ocular Muscle ◽  
Superior Oblique

Purpose: To describe the possibility of complex strabismus surgical simulation on goat eyes. Methods: The goat eyes were procured from local slaughterhouse with retained extra ocular muscle tissues. The obtained eyes were inspected for globe integrity, muscle quality, muscle length, and the surrounding teno-conjunctival layers. The included eyes were then segregated for surgical simulation based on their insertion and orientation (as oblique or recti), and they were mounted on a mannequin head, with a fixation suture at free end to simulate the resting tension. Additionally, as per necessary, extra muscles were also transplanted along desired sites to simulate human extra ocular muscle anatomy. Results: The inferior oblique, superior oblique, and all other four recti were successfully simulated in varying proportions in more than 50 eyes. Primarily, by simulating the lateral rectus, inferior rectus, and the inferior oblique muscle, staged weakening procedures of inferior oblique were successfully practiced (Fink’s recession, Park’s recession, Elliot and Nankin procedure, total anterior positioning, and antero-nasal trans-position or Stager’s procedure). Similarly, by simulating superior rectus, inferior rectus, lateral rectus, and the medial rectus muscles, half width transposition, full width transposition, and other complex procedures were practiced (Knapp’s procedure, augmented Knapp’s, Nishida’s procedure, Faden operation, and Y splitting procedure). Furthermore, by simulating superior oblique and the superior rectus muscles, superior oblique tuck, posterior tenectomy, loop tenotomy, and Harada Ito procedures were successfully practiced. Conclusions: On goat eyes, the complex strabismus surgical procedures can be successfully simulated and practiced after re-organizing the existing muscles in different patterns.

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