Use of Yoked and Differential Prisms to Improve Posture

This paper presents cases of postural changes, and the use of prisms to relieve symptoms, caused by A and V syndromes (with a suggestion as to their cause); asymmetry of the position of the mastoid process; facial asymmetry from disparate growth rate of the skull; slack-jaw; Duane’s syndrome and 6th Nerve palsy, as well as stooping in elderly patients. The paper does not consider the treatment and alleviation of symptoms experienced by patients who have suffered mild traumatic brain injury, although Yoked and Differential prisms are used in its treatment ; this is outside the scope of this paper. The method of examining the patient and prescribing the prisms is described.

Bilateral Type-I Duane's Retraction Syndrome with bilateral Crocodile Tears: A Case Report

Background: Duane's retraction Syndrome is a congenital form of strabismus characterized by horizontal eye movement limitation and globe retraction with palpebral fissure narrowing in attempted adduction. It may be associated with co-existing ocular and systemic pathologies. Crocodile tears, or a paradoxical gustatory lacrimal reflex can be either congenital or acquired. The congenital cases typically are associated with Duane’s syndrome in most of the cases.Case: We present in our case report, uncommon case of bilateral Duane’s syndrome with bilateral crocodile tears - both of which can be assumed to be of probably central origin. Though several cases have been reported, there are very few from the Indian subcontinent. Here, we also review the literature of the syndrome with crocodile tears.Conclusion: All cases of Duane’s retraction syndrome warrant a thorough screening for coexisting ocular and systemic abnormalities. Ours is a classic report of bilateral Duane’s syndrome with bilateral congenital crocodile tears, the coexistence of these two anomalies emphasising the aetiology to be anomalous innervation occurring at central level i.e. is brain stem.