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

We describe two cases with complaints of atypical headache who were initially diagnosed as having psychiatric problems, but who, after careful evaluation, were found to have an underlying eye disorder. Both patients were known to have an ophthalmic history. Patient A, a 21-year-old female, presented with severe headache, which was so disabling that she was declared unfit for work. A diagnosis of tension headache was made and she received psychological treatment with neurofeedback, homeopathy and acupuncture, which had no effect. Patient B, a 26-year-old male, complained of extreme photophobia, nausea and dizziness. The patient was diagnosed as having a conversion disorder and was admitted to a psychiatric clinic and given psychotropic treatment. Careful ophthalmological examination revealed that an ocular deviation was causing the symptoms in both patients and could be treated appropriately with strabismus surgery. These cases emphasise the importance of a thorough general medical and ophthalmic history and proper examination at all times without putting a psychiatric stigma on the patient.
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PMID:[Ocular deviation as the cause of "psychiatric" problems]. 2653 Jan 17

Superior Canal Dehiscence Syndrome (SCDS) causes auditory and vestibular symptoms. Following surgical repair of the dehiscence, patients often experience dizziness and imbalance. This case report describes a postoperative vestibular exercise program, focusing on the principles of central compensation and habituation, and how it was modified for a patient with delayed progress secondary to strabismus and visual vertigo. A 63-year-old male with history of strabismus eye surgery, right hearing loss, aural fullness, and sensitivity to loud sounds was referred for vestibular rehabilitation (VR). He was seen for one preoperative and six postoperative PT visits over eight months. Outcome measures two weeks postoperative were as follows: Dizziness Handicap Inventory (DHI) 38/100; Timed Up & Go (TUG) 9.92 seconds; Dynamic Gait Index (DGI) 16/24; and a 3-line difference in Dynamic Visual Acuity (DVA). Improved outcomes at discharge included: DHI 18/100; TUG 6.87 seconds; DGI 23/24; and 1-line difference in DVA. He was able to return to work and previously enjoyed recreational activities. Postoperative vestibular rehabilitation programs are functionally and symptomatically beneficial following surgical repair for SCDS. Deviations from expected recovery should be addressed to achieve optimal outcomes as demonstrated in this complicated case report.
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PMID:Vestibular rehabilitation following surgical repair for Superior Canal Dehiscence Syndrome: A complicated case report. 2889 20

A 24-year-old male athlete, injured by a cricket bat during training, was transferred to the hospital with an open head bleeding trauma in the medial part of his right eye. He was conscious, with no memory loss and dizziness. A medial orbital wall fracture (MOWF) with a foreign body presence was depicted in X-ray. Head computed tomography scan confirmed initial diagnosis and revealed the complete fracture of ethmoid sinuses. Temporary sutures were placed initially to close the wound and prevent trauma's infection. The ophthalmological exam revealed strabismus of the right eye due to medial rectus muscle entrapment and consequent diplopia in the horizontal gaze. After two weeks, surgery was planned to remove the foreign body, restore eye mobility, and correct diplopia. The wooden foreign body (2.5cm x 1cm) was removed with immediate decompression of the medial rectus muscle. The fracture was repaired by an open approach, a mesh net was placed and sutured to the periosteum for bone stabilization and regeneration. Fifteen days postoperatively, visual acuity was 10/10, ocular mobility was normal, and diplopia disappeared. Imaging is essential in diagnosis' confirmation and reconstructive surgery planning, without postoperative complications and complete patient's rehabilitation. The current report highlights the value of reconstructive surgery in orbital structures' preservation in complex MOWF cases. In such cases, the foreign body that entraps medial rectus muscle should be removed in time in order to prevent the orbital content displacement towards the gap created by the fractured bone with consequences enophthalmos and diplopia, as well as consecutive intraorbital infections. Eye preservation in the correct position eliminates strabismus.
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PMID:A Medial Orbital Wall Fracture From Cricket Bat During Training: Surgical Approach. 3321 49


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