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2008 Series : January 15, 2008

December 30, 2008  |  December 23, 2008  |  December 16, 2008  |  December 9, 2008  |  December 2, 2008  |  November 25, 2008  |  November 18, 2008  |  November 11, 2008  |  November 4, 2008  |  October 28, 2008  |  October 21, 2008  |  October 14, 2008  |  October 7, 2008  |  September 30, 2008  |  September 23, 2008  |  September 16, 2008  |  September 9, 2008  |  September 2, 2008  |  August 26, 2008  |  August 19, 2008  |  August 12, 2008  |  August 5, 2008  |  July 29, 2008  |  July 22, 2008  |  July 15, 2008  |  July 8, 2008  |  July 1, 2008  |  June 24, 2008  |  June 17, 2008  |  June 10, 2008  |  June 3, 2008  |  May 27, 2008  |  May 20, 2008  |  May 13, 2008  |  May 6, 2008  |  April 29, 2008  |  April 22, 2008  |  April 15, 2008  |  April 8, 2008  |  April 1, 2008  |  March 25, 2008  |  March 18, 2008  |  March 11, 2008  |  March 4, 2008  |  February 26, 2008  |  February 19, 2008  |  February 12, 2008  |  February 5, 2008  |  January 29, 2008  |  January 22, 2008  |  January 15, 2008  |  January 8, 2008  |  January 1, 2008

To see views enlarged, click on the individual pictures...

This is the appearance
of the right lateral
rectus after it was
initially engaged on a muscle hook and before any further dissection.
A discreet muscle that follows the course of the inferior oblique is being held up after being dissected from the lower border of the lateral rectus. The appearance of the right lateral rectus at the conclusion of the muscle procedure and before closing the conjuntiva.

A 30-year-old woman presents with a complaint of her right eye “turning in again"!  She also notes that her right eye is “lower” than the left particularly when she looks to the left.  Her vision is OD 20/400 and OS 20/20.  She denies diplopia, not surprising with the deep amblyopia in the right eye.  Refraction is OD +4.50 +1.50 x 87, OS +0.50.  She does not wear glasses now and never has.  She brought medical records that indicated that she had a recession of the right medial rectus 4.0 mm and a resection of the right lateral rectus 7.0 mm at age 11 years.

1.  Considering the history, this patient likely had:   
 

a. anisometropic amblyopia
b. a complication at the first surgery
c. little likelihood of diplopia
d.  some restriction to forced ductions in the right eye
e. all of the above

2.  The likely diagnosis of the muscle condition is:  
 

a. sixth nerve palsy, late occurring
b. inferior oblique paresis
c. Heiman-Bielschowsky phenomenon
d.  inferior oblique inclusion
e. all of the above

3.  The condition occurring in this lady is: 
 
a. not uncommon
b. best treated with inferior oblique myectomy
c. something that can occur when resecting the lateral rectus muscle
d.  usually avoided with good technique
e. all of the above

For answers to the above, click here on or after January 22, 2008.