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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tobacco smoke is composed of as many as 4,000 active compounds, most of them toxic on either acute or long-term exposure. Many of them are also poisonous to ocular tissues, affecting the eye mainly through ischemic or oxidative mechanisms. The list of ophthalmologic disorders associated with cigarette smoking continues to grow. Most chronic ocular diseases, with the possible exception of diabetic retinopathy and primary open-angle glaucoma, appear to be associated with smoking. Both cataract development and age-related macular degeneration, the leading causes of severe visual impairment and blindness, are directly accelerated by smoking. Other common ocular disorders, such as retinal ischemia, anterior ischemic optic neuropathy, and Graves ophthalmopathy, are also significantly linked to this harmful habit. Tobacco smoking is the direct cause of tobacco-alcohol amblyopia, a once common but now rare disease characterized by severe visual loss, which is probably a result of toxic optic nerve damage. Cigarette smoking is highly irritating to the conjunctival mucosa, also affecting the eyes of nonsmokers by passive exposure (secondhand smoking). The dangerous effects of smoking are transmitted through the placenta, and offspring of smoking mothers are prone to develop strabismus. Efforts should be directed toward augmenting the campaign against tobacco smoking by adding the increased risk of blindness to the better-known arguments against smoking. We should urge our patients to quit smoking, and we must make them keenly aware of the afflictions that can develop when smoke gets in our eyes.
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PMID:The association between cigarette smoking and ocular diseases. 963 2

Improvements in the management of strabismus are largely dependent on making the specific diagnosis and differentiating patterns of strabismus. This finding is especially true in the management of superior oblique paresis because there are various types. Recent observation suggests that superior oblique paresis may be associated with a lax superior oblique tendon and that the cause of the paresis is not always neurogenic. Some authorities have suggested using the traction test of the superior oblique to determine whether the superior oblique tendon is lax. If it is lax, the treatment of choice would be a tightening procedure of the superior oblique such as the superior oblique tuck. Adjustable-suture strabismus surgery has reduced the incidence of repeat operations; however, adapting the procedure to the fornix incision has been difficult. The use of a scleral traction suture that retracts the conjunctiva to expose the muscle suture area has been useful for fornix surgery. The rectus muscles supply circulation to the anterior segment via the anterior ciliary vessels, which are routinely interrupted during strabismus surgery. Various procedures have recently been described to preserve the anterior ciliary vessels, and these procedures will be useful in patients who are predisposed to anterior segment ischemia. In the 1950s, inferior oblique weakening procedures were deemed dangerous and unpredictable. Recent advances in the understanding of inferior oblique physiology and fascial relationships have inspired the development of a new inferior oblique weakening strategy--the anteriorization procedure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgical techniques of strabismus. 1014 90

The blood-aqueous barrier (BAB) in experimentally induced anterior segment ischemia (ASI) following strabismus or retinal detachment surgery in pigmented rabbits was evaluated by laser flare photometry. Four simultaneous rectus tenotomies produced a significantly higher flare value on the 1st postoperative day. Obstruction of one or two vortex veins produced significantly high flare values on the 1st and 3rd postoperative days. Scleral buckling with interference of one vortex vein produced a higher flare value than that with buckling alone. Interference of three vortex veins by diathermy and the encircling procedure produced serious ASI. Disruption of BAB in ASI can be detected quantitatively with laser flare photometry. Introduction of prostaglandin synthetase inhibitor resulted in a significant reduction of flare values following surgery. Prostaglandin synthetase inhibitor can partly ameliorate BAB disruption.
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PMID:Blood-aqueous barrier disruption in experimental anterior segment ischemia in rabbit eyes. 1022 5

Starting from a clinical case, the paper presents a rare complication of the strabismus and retinal detachment surgery: the anterior segment ischemia syndrome. In this context, we discuss the clinical and pathogenetic circumstances of apparition, underlining the great importance of primary prophylaxis.
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PMID:[The anterior segment ischemia syndrome]. 1041 17

Anterior segment ischemia is a rare but well-known complication of extraocular muscle surgery.(1) Several surgical techniques have been used to prevent this complication in high-risk patients. A number of studies have suggested that microvascular dissection and preservation of the anterior ciliary vessels during strabismus surgery may reduce the risk of ischemic complications. (2-4) We present a case in which anterior segment ischemia occurred despite the use of this vessel-sparing technique.
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PMID:Anterior segment ischemia after strabismus surgery with microvascular dissection. 1067 73

During the past 2 decades, the introduction of functional endoscopic sinus surgery (FESS) has dramatically improved the treatment of sinus disorders. However, a variety of orbital complications have been reported, including optic nerve damage, hemorrhage, infection, compromise of the lacrimal drainage apparatus, and strabismus. At least 10 cases have reported damage to the medial rectus muscle. (1-8) Treatment options for such patients have been limited, especially because most are adults at risk for anterior segment ischemia after transposition of vertical rectus muscles. We describe 2 patients whose medial rectus myectomies were repaired by using nonabsorbable "hang-back" sutures in combination with a botulinum toxin (Botox) injection of the antagonist lateral rectus muscle. Good primary position alignment was achieved in both patients, and one patient was able to regain binocular function. We recommend this surgical approach, especially in patients at increased risk for anterior segment ischemia.
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PMID:Treatment of subtotal medial rectus myectomy complicating functional endoscopic sinus surgery. 1118 80

In the past year experimental studies have analyzed the ease with which specific sutures can be adjusted, have investigated ways to prevent adhesions in animal models, and have studied variations of the inferior oblique at the surgical capture site. Our knowledge of rectus extraocular muscle pulleys continues to improve, and the value of botulinum toxin type A in the treatment of several conditions has been further documented. New surgical techniques include slanted recessions of the lateral rectus muscles, combined monocular resection and bilateral anterior transposition of the inferior oblique, and intraoperative use of acetylcholine during inferior oblique myectomy. Favorable results have been reported after clinically important modifications to the superior oblique muscle silicone expander and anterior transposition of the inferior oblique procedures, as well as after bilateral inferior rectus muscle recession in dysthyroid ophthalmopathy. Conjunctival inclusion cysts, anterior segment ischemia despite microvascular dissection, and corneal topographic changes are reported as complications occurring after strabismus surgery. Recent publications discussing these issues are reviewed here.
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PMID:Eye muscle surgery. 1114 99

Snapping or tearing of an extraocular muscle refers to its rupture across its width, usually at the junction between muscle and tendon several millimeters behind the insertion. Tearing occurs during strabismus or retinal reattachment surgery, or after trauma. If the proximal end of the muscle cannot be located, transposition procedures are necessary to achieve ocular realignment. These surgical procedures carry the risk of anterior segment ischemia, especially in the elderly. Anterior transposition of the inferior oblique muscle has been used for the treatment of inferior oblique overaction, especially in the presence of a dissociated vertical deviation, and in patients with fourth nerve palsy. We transposed the inferior oblique muscle insertion in a 73-year-old woman with a snapped inferior rectus muscle.
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PMID:Anterior transposition of the inferior oblique muscle as the initial treatment of a snapped inferior rectus muscle. 1118 75

Anterior segment ischemia is a rare but potentially serious complication of strabismus surgery. Anterior ischemia typically occurs after surgery on 3 or 4 rectus muscles. Advanced age, dysthyroid ophthalmopathy, and a history of previous strabismus surgery are known risk factors for this complication. This report reviews the case of a healthy 50-year-old patient who developed anterior segment ischemia after surgery on 2 rectus muscles.
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PMID:Anterior segment ischemia after surgery on 2 vertical rectus muscles augmented with lateral fixation sutures. 1164 44

The immature visual system is vulnerable to adverse events. Periventricular leukomalacia (PVL), an end-stage lesion after hypoxia-ischemia at gestational age 24-34 weeks affecting the visual radiation, has become a principal cause of visual impairment in children. Cerebral visual dysfunction caused by PVL is characterized by delayed visual maturation, subnormal visual acuity, crowding, visual field defects, and visual perceptual-cognitive problems. Magnetic resonance imaging is the method of choice for diagnosing this brain lesion, which is associated with optic disk abnormalities, strabismus, nystagmus, and deficient visually guided eye movements. Children with PVL may present to the ophthalmologist within a clinical spectrum from severe visual impairment in combination with cerebral palsy to only early-onset esotropia, normal intellectual level and no cerebral palsy. Optimal educational and habilitational strategies need to be developed to meet the needs for this group of children.
Strabismus 2002 Jun
PMID:Visual and perceptual characteristics, ocular motility and strabismus in children with periventricular leukomalacia. 1222 99


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