PURPOSE To compare the localization and density of collagens I, IV, VI, and elastin, the major protein components of connective tissue, in the inferior oblique muscle of patients with overelevation in adduction and in controls and to characterize changes that develop following surgery. Biomechanical studies suggest that the connective tissue matrix plays a critical role in extraocular muscle fu...

PURPOSE To assess the incidence and investigate the functional impact of postoperative overcorrection following primary unilateral inferior oblique muscle recession and myectomy for inferior oblique overaction. METHODS A retrospective study of 79 consecutive patients undergoing inferior oblique myectomy (43) or recession (36) with a minimum 6 months of postoperative follow-up. All underwent o...

OBJECTIVES To present the outcomes of unilateral inferior oblique myectomy performed in patients with inferior oblique overaction due to superior oblique palsy. MATERIALS AND METHODS Twenty-seven eyes of 27 patients that underwent inferior oblique myectomy surgery for superior oblique palsy between 2002 and 2008 were included. Inferior oblique overaction scores (between 0-4) at preoperative, ...

PURPOSE To compare the outcomes of surgical procedures in the treatment of inferior oblique muscle overaction (IOOA) as a common disorder of ocular motility. METHODS This retrospective study was performed on patients with primary and secondary IOOA who underwent three surgical treatment procedures including disinsertion, myectomy and anterior transposition, between 2001 and 2011. Type of stra...

PURPOSE Recurrence of inferior oblique overaction (IOOA) after recession or anterior transposition of the inferior oblique (IO) muscles is a common problem. We have been treating such cases by nasal myectomy of the IO, where a segment of approximately 5 mm is removed from the nasal portion, leaving the temporal portion of the IO with its insertion and its ancillary origin, the neurofibrovascula...

PURPOSE To report the association of Marcus Gunn jaw-winking phenomenon and pseudo inferior oblique overaction. METHODS Case report. RESULTS A 21-year-old woman presented with right eyelid elevation on the chewing movement since infancy. Examination showed that both Marcus Gunn jaw-winking phenomenon and pseudo inferior oblique overaction coexist in this patient. CONCLUSION The associatio...

PURPOSE The purpose of the present study is to evaluate the therapeutic effects of slanting muscle insertions for "A" and "V" exotropia. METHODS We performed slanting recession and resection of medial or lateral rectus muscles. A slanting surgical incision creating a 3-4 mm difference between the upper and lower margins of the muscles was performed in 28 patients with "A" or "V" exotropia ( "...

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...

Retroplacement and torsional manipulation of the globe during forced duction testing provide an exaggerated traction test of the oblique muscles, allowing graded evaluation of superior oblique and inferior oblique tightness. On a scale from 0 to 4 +, normal superior oblique tightness averages 1.5+, and normal inferior oblique tightness averages about 1+. The degree of superior oblique or inferi...

INTRODUCTION Inferior oblique overaction (IOOA) can be primary or secondary, isolated or combined to other types of horizontal deviation, mostly with esotropias. Surgical weakening of IOOA means several techniques like; recession, myotomy, myectomy, anteroposition etc. GOALS we analyzed the effect of inferior oblique muscle surgical weakening comparing two groups of patients with primary hype...