A full-term female baby was diagnosed as having Apert syndrome with craniosynostosis, hypertelorism, syndactyly, polydactyly, and cleft plate. At her first ophthalmic visit at 8 months old, she was noted to have bilateral exophthalmos with epiblepharon on her lower lids, exotropia, and right inferior oblique muscle overaction (IOOA) and manifested right dissociated vertical deviation (DVD). The...

When an eye becomes deviated in early childhood, a person does not experience double vision, although the globes are aimed at different targets. The extra image is prevented from reaching perception in subjects with alternating exotropia by suppression of each eye's peripheral temporal retina. To test the impact of visual suppression on neuronal activity in primary (striate) visual cortex, the ...

PURPOSE To report orthoptic changes after photorefractive keratectomy (PRK). METHODS This interventional case series included 297 eyes of 150 patients scheduled for PRK. Complete ophthalmologic evaluations focusing on orthoptic examinations were performed before and 3 months after PRK. RESULTS Before PRK, 2 (1.3%) patients had esotropia which remained unchanged; 3 (2%) patients had far exot...

We studied the relationship between eye position in the awakened state and in the surgical plane of anesthesia in orthophoric and horizontal strabismus patients. We classified 105 orthophoric and horizontal strabismus patients into 5 groups, measured the eye position at the primary position by photographic measurement of the corneal reflex positions and undertook a quantitative study of eye pos...

Suppression scotomas and retinal projection (retinal correspondence) were measured in six intermittent exotropes during deviation. Measurements used red-green anaglyph stimuli presented on a black background which could be varied from 3.4 minutes of arc to 3 degrees 24'. Results showed non-suppression of all points between the fovea and the diplopia point. Harmonious anomalous retinal correspon...

BACKGROUND The purpose of this study was to evaluate the efficacy of a quantitative analysis method for comitant exotropia using video-oculography (VOG) with alternate cover. METHODS Thirty-four subjects with comitant exotropia were included. Two independent ophthalmologists measured the angle of ocular deviation using the alternate prism cover test (APCT). The video files and data of changes...

BACKGROUND Dissociated horizontal deviation is one of several conditions that manifest unequal horizontal deviations depending on which of the 2 eyes is fixating. PURPOSE To describe the reversed fixation test as an essential tool to establish the diagnosis of dissociated horizontal deviation. METHODS Analysis of 4 case scenarios depicting the utility of the reversed fixation test. RESULT...

An 11-year-old boy developed generalized tetanus complicated by a supranuclear gaze palsy and exotropia. This case led us to include supranuclear palsy in an expanded definition of cephalic-tetanus.

We report the effects of unilateral recession-resection surgery of the horizontal recti muscles with inferior displacement and augmented anterior transposition of the inferior oblique muscle with a posterior intermuscular suture in a patient with large exotropia and considerable hypertropia.