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Clinical Strabismus Management: Principles and Surgical by Arthur L. Rosenbaum MD, Alvina Pauline Santiago MD

By Arthur L. Rosenbaum MD, Alvina Pauline Santiago MD

Introducing a textual content that gives assistance for the clinician within the review and administration of all kinds of strabismus in either adults and youngsters. concentrating on medical administration, this article places into point of view glossy diagnostic exams, and discusses the diversity of remedies to be had as soon as a case of strabismus has been evaluated. Covers either average and cutting edge surgical concepts by using colour intraoperative pictures. additionally discusses ideas of surgical administration and the various surgeries widespread within the administration of those complicated difficulties.

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Bremer D L, et al: Cycloplegic refraction in esotropic children: Cyclopentolate versus atropine. Ophthalmology 1981:88:1031. 47. Rubin S E . Wagner RS: Ocular torticollis. Surv Ophthalmol 1986:30:366. 48. Simons K: A comparison of the Frisby, Random-Dot E. TNO. and Randot circles stereotests in screening and office use. Arch Ophthalmol 1981:99:446. 49. Simons K. Elhatton K: Artifacts in fusion and stereopsis testing based on red/green dichoptic image separation. J Pediatr Ophthalmol Strabis­ mus 1994:31:290.

The height at which bifocals arc set depends on the patient’s age, but the ultimate goal is for the child to spontaneously use the bifocal for near. In general, bifocals bisect the pupil in younger children and may be set at the level of the lower limbus or lower lid in older (school-age) children. , induced prisms in anisometropia). A N O M A LO U S HEAD P O ST U R E Anomalous head posture may not be immediately obvious to the examiner and requires a systematic evaluation. Old photographs demonstrating the abnormality should be re­ viewed.

Top series from left to right: + 7, +2, +3, + 4 overaction. Bottom series from left to right: - 1, -2, - 3, - 4 underaction. apparent underaction of the right medial rectus muscle may be observed on left gaze. If true underaction of the right medial rectus muscle is present, the underaction should also be observed on ductions (which would not be expected in this case). An “ inhibitional palsy” results when equal innervation is sent to an agonist to contract and to an antagonist to relax. With inhibitional palsy of the contralateral antagonist in a patient with right SO palsy, less innervation is required to the antagonist of the right SO— the right IO— w hen the eyes look to the left and up (Sherrington's law').

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