Published online Aug 12, 2009.
https://doi.org/10.4068/cmj.2009.45.2.136
A Case of Esotropia at Near and A Type Exotropia at Distance
Abstract
We report the surgical correction of a case of strabismus showing reverse directional deviation. A 9-year-old girl showed reverse directional strabismus according to fixation distance. We performed a posterior fixation suture on the medial rectus 12 mm posterior from the scleral insertion and temporal superior oblique tenotomy. The follow-up after 18 months was as follows: The esotropia at near was reduced from 12 prism diopters to 4, whereas there was no change in the amount of exotropia at distance. The 24 prism diopters A type vertical incomitance was converted into 2 prism diopters V type vertical incomitance. The posterior fixation suture on the medial rectus was effective in reducing esotropia at near but there was no effect on exotropia at distance.
Fig. 1
Preoperative photographs of a patient. (A) A type exotropia with bilateral superioir obligue overaction. (B) Esotropia at near.
Fig. 2
Postoperative photographs of a patient showing V type exotropia at distance.
Fig. 3
Preoperative fundus photographs showing incyclotorsion of both eyes.
References
-
Urist M. The fusional balancing innervation in heterophoria for control of antipodal deviations at a null point: a previously undescribed type of binocular innervation. J Pediatr Ophthalmol 1976;13:65–71.
-
-
Clarke WN, Noel LP. Antipodean strabismus. Am Orthopt J 1984;34:104–109.
-
-
von Noorden GK. Indications of the posterior fixation operation in strabismus. Ophthalmol 1978;85:512–520.
-