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 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Endemic cretinism includes two syndromes: a more common neurological disorder with brain damage, deaf mutism, squint and spastic paresis of the legs and a less common syndrome of severe hypothyroidism, growth retardation and less severe mental defect. Both conditions are due to dietary iodine deficiency and can be prevented by correction of iodine deficiency before pregnancy. Endemic cretinism is now included in the spectrum of the effects of iodine deficiency in a population termed the 'iodine deficiency disorders (IDDs)', which also includes a wide range of lesser degrees of cognitive defect that can be prevented by the correction of iodine deficiency. Iodine deficiency is now recognised by the World Health Organization (WHO) as the most common preventable cause of brain damage with in excess of 2 billion at risk from 130 countries. A global United Nations (UN) programme of prevention has achieved 68% household usage of iodised salt by the year 2000 compared with less than 20% prior to 1990.
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PMID:Cretinism revisited. 2017 69

Worth's four dot test was first described one hundred years ago. Despite many technological advances in equipment and techniques during the last century, this simple test is still used routinely by many strabismus specialists. It is an invaluable test when used in the evaluation of longstanding and acquired strabismus in adults and in the management of complex diplopia. Techniques using the test include selecting an optimal prism, assessing the effect of a prescribed prism or compensatory head posture on the range of binocular single vision, identifying non-organic responses, diffe1rentiating monocular from binocular diplopia, especially when they co-exist, and blurred from double vision in older patients with divergence paresis. It also can be used with prisms preoperatively to determine the risks of postoperative diplopia and give clues to the presence of torsion or a visual field defect.
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PMID:The "worth" of the worth four dot test. 2114 94

A small esodeviation detected in an adult may represent an acquired event caused by a number of different mechanisms. These deviations may be comitant or incomitant, occur with or without diplopia and appear in association with other ocular or neurological findings or in isolation. The mechanisms include lateral rectus dysfunction, supranuclear gaze disturbances, anomalies in the vergence system, the influence of the near synkinesis and certain restrictive components. The presence of a small, acquired esodeviation may have neurological significance that may influence diagnosis and management decisions.1,2 Conditions such as divergence paralysis and convergence spasm are described in the classic literature with large esodeviations and obvious clinical features.3-7 They are not a common occurrence in most strabismus practices but are recognized readily when they occur. More subtle presentations of these entities are seen far more frequently and may be so small, or co-exist with other ocular findings, as to be overlooked. It is likely that with many clinical disorders like divergence paresis and convergence spasm that they present as a spectrum of dysfunction; it is the small end of that spectrum that will be discussed.
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PMID:Neurological significance of small esodeviations. 2114 81

We describe a report of a child with a horner's syndrome and sixth nerve paresis secondary to a petrous internal carotid artery (ICA) aneurysm. Management of this condition involved coiling of the aneurysm and the use of botulinum toxin to manage his strabismus and associated symptoms.
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PMID:Horner's syndrome and sixth nerve paresis secondary to a petrous internal carotid artery aneurysm. 2127

Force-length recordings were made from isolated human eye muscles during strabismus surgery in local, eye-drop anesthesia in 32 adult patients. From each muscle three recordings were made: (I) while the patient looked with the other eye into the field of action of the recorded muscle, (2) looked ahead, and (3) looked out of the field of action of the recorded muscle. Non-innervated eye muscles (state 3) had an approximately exponential relation between force and length. During contraction evoked by letting the patient look ahead or into the field of action of the muscle (states 1 or 2), the relation between force and length was grossly linear. The approximate spring constants of horizontal rectus muscles that had not been operated on before ranged from 2 to 4 g/mm. In palsies, the degree of muscle paresis could be quantified accurately using this method and, accordingly, cases of true superior oblique palsy could be well differentiated from strabismus sursoadductorius (= upshoot in adduction) that may mimic a superior oblique palsy. In seven patients with Graves' disease of recent onset, affected muscles were found to be very stiff when the other eye looked ahead. It was expected that these stiff muscles would be able to shorten to some extent but would not be able to lengthen, due to fibrosis of the muscle. We found, however, that the affected muscles lengthened considerably when the other eye looked out of the field of action of the muscle. This implies that, in these cases of Graves' disease of recent onset, the raised muscle tension and reduced elasticity of the affected muscles and, hence, the strabismus were primarily caused by active muscle contraction, not by fibrosis.
Strabismus 1994
PMID:Force-length recording of eye muscles during local-anesthesia surgery in 32 strabismus patients. 2131 97

If preoperative examinations indicate postoperative diplopia, we generally would dissuade a patient from a squint operation. In this situation, a reliable test for diplopia can be done by injection of Botulinum toxin into an eye-muscle. Thus a predominantly transient paresis is produced during which there is parallelism for a sufficient period of time, so that the patient has time enough to experience disturbing double vision or its absence. In all 31 patients of this study a clear decision for or against an operation was possible, only in three cases was an operation contraindicated.
Strabismus 1993
PMID:Botulinum toxin as a tool for testing the risk of postoperative diplopia. 2131 59

Bell's palsy is an idiopathic unilateral paresis or paralysis of the facial nerve. The authors describe a 3-month-old infant with Bell's palsy and detail the investigation and management appropriate for the pediatric age group.
J Pediatr Ophthalmol Strabismus 2011 Feb 15
PMID:Bell's palsy in a 3-month-old infant: recommendations for management of pediatric cases. 2132 4

Ocular abnormal head posture (AHP) or torticollis is a frequent sign in pediatric pathology The incidence is 5.6% in ophthalmological practice and 3.19% in pediatric ophthalmological practice. The abnormal head posture is adopted to improve visual acuity maintain binocular single vision, center residual visual field with the body or for cosmetic reasons. Face turn is the most frequent abnormal head posture in pediatric ophthalmology. The more common diseases causing face turn are Duane syndrome, congenital fibrosis of extraocular muscles, nystagmus, refractive errors, visual field defects. The most frequent ocular causes of head tilt in children are congenital nystagmus, superior oblique paresis, dissociated vertical deviation, Brown syndrome, refractive errors. Chin-up or chin-down abnormal head postures are most commonly caused by "A" and "V"-pattern strabismus, palpebral ptosis, nystagmus, refractive errors. Torticollis is not a diagnosis, but it is a sign of an underlying disease. There are ocular diseases which diagnosis is straightforward for general practitioner, pediatricians or pediatric surgeons (horizontal nystagmus, lateral rectus paralysis, ptosis, esotropia), but others less obvious (superior oblique paralysis, Duane syndrome, A and V-pattern strabismus, torsional nystagmus) because of the compensatory head posture, and these last disorders are predisposed to confusion with congenital AHP Interdisciplinary collaboration between ophthalmologist, pediatrician, pediatric surgeon, ENT specialist and neurologist is mandatory in establishing the etiology of AHP Every child with AHP must be examined by an ophthalmologist.
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PMID:Understanding ocular torticollis in children. 2177 81

Anterior plagiocephaly is a craniofacial anomaly related to premature uni-lateral synostosis. We present a case of anterior plagiocephaly with vertical strabismus, overaction of the contralateral superior oblique muscle and an A pattern. A detailed ophthalmic examination and radio-imaging were done. The patient underwent strabismus surgery and resolution of the strabismus was obtained. Plagiocephaly has been reported to simulate ipsilateral superior oblique muscle paresis. We report a rare occurrence of contralateral superior oblique muscle overaction in an adult with anterior plagiocephaly.
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PMID:A doubly paradoxical vertical eye deviation with an a pattern strabismus in plagiocephaly: management and a case report with outcome. 2199 59

Vertical strabismus can be associated with paretic or restrictive causes. Paretic causes may be due to a weak muscle or paresis, or to a total lack of muscle function caused by a third, fourth or sixth cranial nerve palsy. When examining a patient with vertical strabismus, it is paramount that we differentiate between a restricted cause and paretic cause. This paper discusses the nonsurgical techniques used in evaluating paretic vertical strabismus. There are no easy methods, and evaluation techniques can vary depending on the cooperation of the patient. It is essential to look at versions and ductions, pattern strabismus, measure in all positions of gaze and evaluate torsion. We know that measuring strabismus, especially in children can be challenging. Afew different tests and techniques are discussed. A review of the literature regarding the different evaluation techniques for vertical strabismus were collated and analyzed.
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PMID:Evaluation techniques for paretic vertical strabismus. 2206 43


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