scholarly journals Surgical Management of Complex Anomalous Head Posture in Idiopathic Infantile Nystagmus

2020 ◽  
pp. 1-4
Author(s):  
Sandra C Ganesh ◽  
Sandra C Ganesh ◽  
Ashwini S Raut ◽  
Shilpa G Rao
Keyword(s):  
Anterior Segment ◽  
Head Tilt ◽  
Rectus Muscle ◽  
Primary Position ◽  
Second Child ◽  
Head Posture ◽  
Infantile Nystagmus ◽  
One Year ◽  
Second Procedure ◽  
Anomalous Head Posture

Idiopathic infantile nystagmus (IIN) is usually associated with a null zone, which is the zone of minimal nystagmus intensity. An anomalous head posture (AHP) is adopted to shift the null zone from an eccentric position to primary position. A complex AHP may include head position involvement in different ocular axes-namely face turn, chin elevation or depression and head tilt or a combination of these. Surgically, various procedures have been described for correction of this condition. We evaluated 2 children aged six and ten years, who presented with shaking of eyes along with presence of a complex AHP. First child had 20 degrees right face turn, 20 degrees right head tilt and 10 degrees of chin elevation. She underwent a combination of 2 procedures-augmented Anderson’s procedure for correction of right face turn and modification of Kestenbaum procedure for right head tilt along with bilateral IR recession, for correction of chin elevation. Postoperatively, AHP was satisfactorily corrected to 5 degrees face turn and minimal head tilt, and it remained stable for one year. The second child had left face turn 15 degrees, with right head tilt of 20 degrees and chin depression 10 degrees. He underwent a combination of 2 procedures-augmented Anderson’s procedure for correction of left face turn and modification of Kestenbaum procedure for right head tilt along with bilateral SR recession, for correction of chin depression. Postoperatively, AHP was satisfactorily corrected to 5 degrees face turn and minimal head tilt, which remained stable over a period of one year. In both cases, AHP was corrected by operating on only 2 muscles in each eye (one horizontal and one vertical) at a time. As both cases presented with combination of both torsional and vertical components of AHP, we decided to treat them both by surgery on a single vertical rectus muscle bilaterally to correct the chin position (elevation or depression), as well as torticollis (transposition of vertical recti, either nasally or temporally as needed). Since a third rectus muscle was not operated upon, there was a lesser possibility of developing anterior segment ischaemia. Additionally, as all components of AHP were corrected in one session, need for a second procedure under general anaesthesia to correct residual AHP was avoided in both cases.

A Method for Rehabilitating Vision after Stroke

Perception ◽  
1997 ◽  
Vol 26 (1_suppl) ◽  
pp. 28-28
Author(s):  
V Virsu ◽  
P Koskela
Keyword(s):  
Eye Movements ◽  
Rectus Muscle ◽  
Eye Position ◽  
Central Vision ◽  
Binocular Fusion ◽  
Primary Position ◽  
Lateral Rectus Muscle ◽  
Correct Function ◽  
One Year ◽  
Voluntary Saccades

We developed a method for rehabilitating eye movements and binocular fusion, and tested the method in one patient. An infarct of the pons caused the paresis of the lateral rectus muscle of the left eye. Beginning from the third week in hospital, the patient was trained in eye movements and binocular fusion. Fusion was made possible by means of prisms that moved the images of targets in central vision to the threshold of fusion in the primary eye position. During practice sessions lasting 0.5 to 2 h daily the patient kept the images fused by making a horizontal head movement when necessary. Several eye-movement sessions were held daily, consisting of voluntary saccades and fixations as far to the left as possible. The strength of the prismatic correction required for fusion decreased, and four months after the onset of stroke the patient could fuse without prisms in the primary position. His binocular vision became practically normal in one year. The plasticity of the visual system can be utilised in rehabilitation by a practice that uses minimal remedial means necessary for correct function at each level of performance.

scholarly journals Surgical treatment of a patient with congenital nystagmus with compensatory head posture: A case report

2020 ◽  
Vol 89 (9-10) ◽  
pp. 515-520
Author(s):  
Alma Kurent ◽  
Dragica Kosec
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Rectus Muscle ◽  
Congenital Nystagmus ◽  
Head Turn ◽  
Primary Position ◽  
Head Posture ◽  
Straight Position ◽  
Lateral Rectus Muscle ◽  
The Right

The correction of compensatory head posture in a congenital nystagmus involves surgical treatment that includes recession and resection of extraocular muscles to move the eccentric null zone to a primary position. A 39-year-old patient presented with an impaired visual acuity and nystagmus that was present since childhood. She had a left head turn with permanent neck pain. At the examination, best corrected visual acuity was 0.4 in both eyes with her glasses. Correction in the right eye was -6.50-1.50/180° and in the left eye -5.50-2.50/180°. Measured objective and subjective angles of squint were +4°, fusion from -3° to +29°, with the presence of stereo vision. During the cover test the nystagmus was present and it enhanced while covering the eye. Ocular motility was not limited. Fundus examination revealed myopic changes in both eyes. Prisms were prescribed, which were well tolerated by the patient. Also, no apparent head turn was noticed while wearing the prisms. Nine months later, the patient underwent a Kestenbaum procedure. Retroposition of the lateral rectus muscle with resection of the medial rectus muscle in the right eye and retroposition of the medial rectus muscle with resection of the lateral rectus muscle in the left eye were performed. After the procedure nystagmus dampened the most in the minimal left position, the head was in a straight position. Two years after the procedure nystagmus dampened the most in the primary position, the head was in a straight position. Nine years after surgery and refractive correction with contact lenses, the visual acuity was 0.8-0.9p in both eyes. The presented case showed that adequate functional and surgical treatment led to a good morphological outcome with improved visual acuity in a patient with congenital nystagmus and a compensatory head posture even in adulthood.

scholarly journals Augmented superior rectus muscle transposition in management of defective ocular abduction

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohamed F. Farid ◽  
Ahmed E. M. Daifalla ◽  
Mohamed A. Awwad
Keyword(s):  
Nerve Palsy ◽  
Rectus Muscle ◽  
Muscle Transposition ◽  
Primary Position ◽  
Superior Rectus ◽  
Sixth Nerve Palsy ◽  
Abnormal Head ◽  
Duane Retraction Syndrome ◽  
Sixth Nerve ◽  
Superior Rectus Muscle

Abstract Background Superior rectus muscle transposition (SRT) is one of the proposed transposition techniques in the management of defective ocular abduction secondary to chronic sixth nerve palsy and esotropic Duane retraction syndrome (Eso-DRS). The aim of the current study is to report the outcomes of augmented SRT in treatment of Eso-DRS and chronic sixth nerve palsy. Methods a retrospective review of medical records of patients with Eso-DRS and complete chronic sixth nerve palsy who were treated by augmented full tendon SRT combined with medial rectus recession (MRc) when intraoperative forced duction test yielded a significant contracture. Effect on primary position esotropia (ET), abnormal head posture (AHP), limitation of ocular ductions as well as complications were reported and analyzed. Results a total of 21 patients were identified: 10 patients with 6th nerve palsy and 11 patients with Eso-DRS. In both groups, SRT was combined with ipsilateral MRc in 18 cases. ET, AHP and limited abduction were improved by means of 33.8PD, 26.5°, and 2.6 units in 6th nerve palsy group and by 31.1PD, 28.6°, and 2 units in Eso-DRS group respectively. Surgical success which was defined as within 10 PD of horizontal orthotropia and within 4 PD of vertical orthotropia was achieved in 15 cases (71.4%). Significant induced hypertropia of more than 4 PD was reported in 3 patients (30%) and in 2 patients (18%) in both groups, respectively. Conclusion augmented SRT with or without MRc is an effective tool for management of ET, AHP and limited abduction secondary to sixth nerve palsy and Eso-DRS. However, this form of augmented superior rectus muscle transposition could result in high rates of induced vertical deviation.

scholarly journals Case Report of Anomalous Head Posture Correction with Low Vision Aid Using Virtual Reality

2020 ◽  
Vol 61 (6) ◽  
pp. 699-705
Author(s):  
Jeong Woo Kang ◽  
Seon Ha Bae ◽  
Joon Hyung Yeo ◽  
Nam Ju Moon
Keyword(s):  
Virtual Reality ◽  
Case Report ◽  
Low Vision ◽  
Head Posture ◽  
Anomalous Head Posture

scholarly journals Intention to have a second child among Chinese women one year after the implementation of selective two-child policy: a cross-sectional survey

The Lancet ◽  
2016 ◽  
Vol 388 ◽  
pp. S96 ◽  
Author(s):  
Xianglong Xu ◽  
Hanxiao Zuo ◽  
Yunshuang Rao ◽  
Lei Zhang ◽  
Lian Lian Wang ◽  
...  
Keyword(s):  
Chinese Women ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Second Child ◽  
Child Policy ◽  
One Year

Mothers' Adjustment to the Birth of a Second Child: A Longitudinal Study on Use of Verbal and Nonverbal Behaviors toward Two Children

1999 ◽  
Vol 84 (1) ◽  
pp. 141-144
Author(s):  
Yasuo Kojima
Keyword(s):  
Longitudinal Study ◽  
Behavioral Strategy ◽  
Nonverbal Behaviors ◽  
Verbal Interactions ◽  
Second Child ◽  
Concurrent Use ◽  
One Year ◽  
Verbal And Nonverbal Behaviors

4 mothers' skillful use of verbal and nonverbal behaviors to their first and second children was examined while each mother was playing with them for about one year after the birth of the second child. Analysis showed that maternal verbal interactions with the firstborn were frequently accompanied by nonverbal interactions toward the secondborn, especially during the first few months postpartum. The concurrent use of verbal and nonverbal behaviors with the two children may be a behavioral strategy for the mother to adjust to the birth of the second child.

scholarly journals Accelerated Corneal Collagen Cross-Linking Using Topography-Guided UV-A Energy Emission: Preliminary Clinical and Morphological Outcomes

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Cosimo Mazzotta ◽  
Antonio Moramarco ◽  
Claudio Traversi ◽  
Stefano Baiocchi ◽  
Alfonso Iovieno ◽  
...  
Keyword(s):  
Anterior Segment ◽  
Case Series ◽  
Cross Linking ◽  
Optic Coherence Tomography ◽  
Retrospective Case ◽  
One Year ◽  
Coma Aberration ◽  
Topographic Astigmatism ◽  
Corneal Collagen

Purpose. To assess the clinical and morphological outcomes of topography-guided accelerated corneal cross-linking. Design. Retrospective case series. Methods. 21 eyes of 20 patients with progressive keratoconus were enrolled. All patients underwent accelerated cross-linking using an ultraviolet-A (UVA) exposure with an energy release varying from 7.2 J/cm2 up to 15 J/cm2, according to the topographic corneal curvature. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, topography, in vivo confocal microscopy (IVCM), and anterior segment optic coherence tomography (AS-OCT) were evaluated preoperatively and at the 1, 3, 6, and 12 months postoperatively. Results. 12 months after surgery UDVA and CDVA did not significantly vary from preoperative values. The average topographic astigmatism decreased from -4.61±0.74 diopters (D) to -3.20±0.81 D and coma aberration improved from 0.95 ± 0.03 μm to 0.88 ± 0.04 μm after surgery. AS-OCT and IVCM documented differential effects on the treated areas using different energies doses. The depths of demarcation line and keratocyte apoptosis were assessed. Conclusions. Preliminary results show correspondence between the energy dose applied and the microstructural stromal changes induced by the cross-linking at various depths in different areas of treated cornea. One year after surgery a significant reduction in the topographic astigmatism and comatic aberration was detected. None of the patients developed significant complications.

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