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Answers: 2007 series -  March 6, 2007 Lecture 43 of 52  NEXT»

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This 10-year-old girl had undergone bimedial rectus recession for congenital esotropia at age 2 years.  Over the past several years she has developed a moderate exodeviation.  Her vision is OD 20/40 and OS 20/20.  Refraction is OD +1.00 sph and OS 0.75 sph.  Her media are clear and the fundus is normal in each eye.

1.  The most important feature(s) present in this girl's presentation is (are):  
 

e -- all of the above except (d)

This girl demonstrates a widened palpebral fissure, limited adduction of the previously operated right eye, and limited adduction.  All of these are key to establishing the proper diagnosis.

 

2.  A likely cause of the above is:   
 

a -- a slipped right medial rectus muscle

The most likely cause of the findings in this girl is a slipped right medial rectus muscle.

 

3.  Appropriate management in this case would be: 
 

d -- resection and advancement of the right medial rectus muscle

The best treatment for this girl is a resection and advancement of the right medial rectus muscle.  The amount would depend in large part on the findings at surgery.

 


Lecture 43 of 52 «Previous Lecture   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52    Next»