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2008 Series -  January 15, 2008 Lecture 51 of 53  NEXT»

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.



Lecture 51 of 53 «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 53    Next»