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STRABISMUS

Subjects
1. Concomitant strabismus
2. Treatment of concomitant
strabismus
3. Paralitic strabismus
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Concomitant strabismus
a condition in which the degree of
strabismus is the same in all directions of
gaze

Strabismus squinting is a condition in which the


eyes are not properly aligned with each other.
It typically involves a lack of coordination
between the extraocular muscles that prevents
bringing the gaze of each eye to the same point in
space and preventing proper binocular vision,
which may adversely affect depth perception.
Strabismus can be either a disorder of the brain
coordinating the eyes or a disorder of one or more
muscles, as in any process that causes a
dysfunction of the usual direction and power of the
muscle or muscles
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CONCOMITENT STRABISMUS
The angle of deviation is the same in all fields of gaze.
Clasification: esotropia and exotropia
Esotropia inward deviation of the nonfixing eye
a. nonaccomodative esotropia the deviation appears after birth.
There is a familial history of strbismus.
the deviation is more than 50 diopters and is the same in all direction.
- amblyopia and abnormal retinal correspondence is develop
-b. accomodative esotropia strabismus it appears because there are
refractive arrors (Hyperopia, astigmatism)
Exotropia the nonfixing eye deviates outward. The deviation is the
same at near and for far.

Treatment
The treatment of strabismus is directed to:
1.determining the type of deviation
2.Determining the cause of deviation
3.Treatment of amblyopia
4.Development of normal vision
5.Corection od alignment
Methods:
Corection of refractive errors spectacles for hyperopia, astigmatism
Correction of amblyopia occlusion of the better eye or first for the
poorer and than for the good eye.
Atropinization of one eye.
Orthoptic treatment for development of normal binocular vision
Surgery for medial muscle in exotropia or extern muscle in
esotropia.

Surgery
Loosening / weakening procedures
Recession involves moving the insertion of a muscle posteriorly
towards its origin.
Myectomy
Myotomy
Tenectomy
Tenotomy

Tightening / strengthening procedures


Resection
Tucking
Advancement is the movement of an eye muscle from its original place
of attachment on the eyeball to a more forward position.

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Transposition / repositioning procedures


Adjustable suture surgery is a method of reattaching
an extraocular muscle by means of a stitch that can be
shortened or lengthened within the first post-operative
day, to obtain better ocular alignment

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PARALITIC STRABISMUS
The motor nerves of the eye may be involved in a variaty of
abnormalities causes by trauma, hemorrhage, cerebral edema,
neoplasm
Is a misalignment of the visual axes that results from paresis, paralysis
or restriction of one or more extraocular muscles. The secondary
deviation is greater than the primary deviation.
In an adult causes diplopia and for neutralization of this appears ocular
torticolis.
For diagnosis is necessary forced duction test (after anestesia of
conjunctiva)
Treatment steroids and vitamins for 6 months and than surgery.