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

The authors present a case of oculo-auricular dysplasia (type Goldenhar) associated with France-schetti's syndrome (mandibulo-facial dysostosis) and complicated by paralytic strabismus and genital malformations. Complete investigation failed to establish a precise aetiology; one suggests an external disturbance in the course of the organogenesis of the branchial arches. Aesthetic improvement was undertaken--removal of epibulbar dermoids, correction of the squint, and ablation of the preauricular appendages; functional orthodontic treatment continues.
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PMID:[Diagnostic and therapeutic problems in a clinical case of oculoauricular dysplasia associated with mandibule-facial dysostosis (Franceschetti-Goldenhar syndrome)]. 71 66

A group of 2205 operations of strabismus in the course of 12 years reveals a clear predominance of operations of dynamic strabismus (94%), as compared with surgery of paralytic strabismus and ocular torticollis on account of nystagmus (6%). This fact provides evidence of a marked ratio of a non-paralytic aetiology of strabismus in the child population. In esotropia, the most frequent type of strabismus, the authors consider as most suitable the technique of weakening of the inner rectus muscles by a dosed elongation according to Gonin-Hollwich, as compared with the classical retroposition of this muscle. In exotropia the authors recommend reinforcing operations only or in combination with a weakening operation of the rectus muscles. The gradual development of application of the technique of surgery of the hyperfunctional lower oblique muscle is in favour of treble partial myotomy (elongation). They operate paretic strabismus when the IIIrd, IVth, VIth nerve are affected and supranuclear paresis of the levators by a complex procedure incl. transposition operations of the functional muscles. The authors operate ocular torticollis after a careful analysis of the congenital nystagmus, using special techniques on the rectus and oblique muscles which adjust the position of the head and bulbs.
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PMID:[Surgical treatment of strabismus in children (a 12-year study)]. 139 35

Botulinum toxin A injection in essential blepharospasmus and hemifacial spasmus is an important alternative to surgical therapy. The toxin is injected into the lateral parts of the lower and upper lid in single doses of one to two nanograms under electromyographic control. The effect is visible after a few days and lasts for several months. The procedure can be repeated several times. A second important application of botulinum toxin A is strabismus. In paralytic strabismus the contracture of the antagonist of the paralyzed muscle can be weakened by local injection of botulinum toxin by means of a needle electrode under electromyographic control. Thus the contracture of the homolateral antagonist can be overcome and not seldom singular binocular vision obtained again. In cases of moderate pareses which recover spontaneously the muscle weakening effect of the toxin on the antagonist helps to restore binocular single vision. In cases of chronic paralytic strabismus the toxin injection into the antagonist facilitates the surgical intervention on the paralyzed muscle. In concomitant strabismus botulinum toxin A is above all valuable in small angle cases, in sensory strabismus, in cases of over- or undercorrection after surgery, and these especially in adults. In congenital esotropia, in commitant squints with large angles and in chronic or intermittent exotropia surgery is the preferred modality of treatment. The best results are obtained with repeated small doses. Generally a 65% reduction of the strabismus angle after two to three injections can be expected. With injections into the lids and the extraocular muscles no general systemic side effects has been observed.
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PMID:[Use of botulinum toxin in ophthalmology]. 219 66

Until now computer models of strabismus have consisted of lengthy calculations based on oculomotor physiology. Such models have been able to demonstrate the pattern of strabismus that would arise from any given muscle abnormality and/or operation. However, it has been difficult to use such models to guide strabismus surgery because the surgeon requires a model that works in the opposite direction. The surgeon requires a model whose input is the pattern of strabismus and output is the muscle operation required. Such a model is described here. Instead of consisting of calculations based on physiology the new model consists of a store of most of the information capable of being generated by an existing strabismus model together with an efficient search procedure. In this paper the potential of the new model is demonstrated by its application to a case of paralytic strabismus.
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PMID:An automated system of strabismus management. A direct approach using a "reverse" model. 264 77

BTX injection has been used for 11 years by 292 ophthalmologists in 8,854 patients aged three months to 90 years in a variety of eye muscle and eyelid disorders. No systemic toxic reaction has occurred, local complications are few, and visual loss has not occurred in any case. In blepharospasm and hemifacial spasm BTX appears to fill an important need, since no other drug is reliably effective and since surgical interventions have substantial side effects. Strabismus cases with active uveitis, hypotony, previous detachment surgery, active thyroid eye disease, and recent paralytic strabismus are often poor candidates for surgical intervention. Some patients in each of these categories were treated effectively and safely by BTX injection. Surgery is clearly the preferred treatment modality in large angle deviations, in chronic paralytic strabismus, in cases where diplopia for a month or two from injection would incapacitate the patient, in nystagmus, in oblique muscle disorders and A-V patterns, where muscles have been misplaced and where restrictions to alignment have been created by disease or prior surgery. Side by side comparisons of surgery and injection in congenital esotropia and in concomitant strabismus of 50 PD or less should result in further clarification of treatment choices as to effectiveness, side effects and cost. BTX is presently available only to clinical investigators using the drug under research protocols.
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PMID:Botulinum toxin therapy of eye muscle disorders. Safety and effectiveness. American Academy of Ophthalmology. 277 91

Between July 1984 and March 1985, 51 injections of type A botulinum toxin were given to 39 patients aged 11 to 81 years with various types of strabismus, including paralytic strabismus, sensory exotropia, consecutive and residual postsurgical deviations and partially accommodative esotropia. All deviations were documented by orthoptic assessment and photography. After treatment the patients were followed for up to 3 years. The beneficial effects of a single injection were modest, and a second injection was often necessary to achieve satisfactory ocular alignment. Thirteen of the 26 patients (50%) with nonparalytic strabismus and 10 of the 13 patients (77%) with paralytic strabismus had a good outcome (final deviation 12 prism dioptres or less). Adverse side effects included transient ptosis and diplopia and inadvertent vertical deviation. Twenty-one consecutive cases of nonparalytic horizontal strabismus treated with adjustable sutures were also reviewed. The results in these patients were more predictable and longer lasting than those in the patients who received botulinum toxin.
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PMID:Injection of type A botulinum toxin into extraocular muscles for correction of strabismus. 360 94

Botulin toxin A was introduced as a treatment in ophthalmology by Dr. Scott of San Francisco. One important application is in cases of blepharospasm, where the toxin is injected into the lateral parts of the lower and upper lid and, if necessary, over the eyebrows in a single dose of 1-2 nanograms, preferably using a needle under electromyographic control. The effect on the blepharospasm is visible after a few days and lasts for several months. The procedure can be repeated several times. The second application is in cases of strabismus. In paralytic strabismus, contracture of the antagonist of the paralyzed muscle can be weakened by local injection of botulin toxin with a coaxial electrode under electromyographic control. Good results were observed in cases of eye muscle disorders in endocrine ophthalmopathy. In concomitant strabismus (exotropia or esotropia) administration of botulin toxin is also possible although a certain paresis of the injected muscle has to be taken into account. The doses for strabismus vary between 1/2 and 2 nanograms of the toxin. The administration of botulin toxin either in blepharospasm or strabismus has no systemic side effects and is a safe procedure if performed under careful electromyographic control. First personal experiences in the treatment both of blepharospasmus as well paralytic strabismus and concomitant strabismus are reported.
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PMID:[Use of botulinum toxin in ophthalmology]. 371 87

The author discusses the possible methods of treatment with botulin (Scott) in cases of blepharospasm, paralytic strabismus, and concomitant strabismus.
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PMID:[The treatment of eye muscle diseases with botulinum toxin]. 404 53

Strabismus surgery with adjustable sutures of absorbable material was performed in 19 patients, aged 8-69 years, who had paralytic strabismus and/or were re-operated. The ocular alignment was assessed at 1 week and 3-12 months post-operatively. In 12 of the patients eye position was stable during that period. Eleven of them had good or moderate binocular vision. However, eye position changed over the follow-up period in about half of the patients with poor binocular vision. No evidence was found for any muscle repositioning by mechanical stress during suture absorption.
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PMID:Adjustable sutures in strabismus surgery. A follow-up study. 716 89

Three patients with various manifestations of the amniotic band syndrome associated with strabismus are presented and discussed. All three cases demonstrate a paralytic strabismus due to a unilateral paresis-paralysis of the medial rectus in one case and of the superior rectus in another. The third case showed a bilateral lateral rectus paralysis. In two cases, the strabismus was accompanied by other ocular manifestations, while in one patient strabismus and amblyopia were the sole ophthalmological findings. In two of the cases, a direct association between the mesodermal bands and the strabismus could be established, while in one case this association might have been incidental. Careful ophthalmological followup and treatment of these cases prevented needless loss of vision while appropriate muscle surgery restored acceptable cosmetic appearance in one case.
J Pediatr Ophthalmol Strabismus
PMID:Amniotic band syndrome and strabismus. 720 45


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