Strabismus - Fundamentals of Clinical Ophthalmology.pdf

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Acknowledgements I gratefully acknowledge BMJ Books for the invitation to author this text on strabismus and to contribute to this series. The books in this series owe much to the experience of past and present generations of clinicians and scientists who are responsible for creating a discipline within which we are privileged to practise. James Wong deserves special mention. As my research assistant, James has assisted in the computer generation of this manuscript and as a trainee ophthalmologist, initially in his first year and now into his second year, he has played a further role as devil's advocate, reflecting the initial difficulties those in training have in understanding strabismus. This has led to a simplification of the text and hopefully a clarity that will make this volume useful to the general clinician, registrar in training and specialist in related disciplines. I also wish to thank Craig Hoyt, Bill Good, and Peter McCluskey. They were generous and patient enough to read the entire manuscript and make incisive comments but any remaining errors are my responsibility alone. This book reflects the influence of teachers and colleagues. A founding generation for modern strabismus in the last 50 years includes Frank Costenbader, Hermann Burian, David Lyle, Phil Knapp, Marshall Parks, Art Jampolsky, Alan Scott, John Pratt-Johnston, Gunter von Noorden, and Robert Reineke who in turn inspire a present generation. This includes Bert Kushner, Art Rosenbaum, and David Guyton. Those in the discipline of neurology who bring science to the topic of strabismus include David Cogan, John Leigh, and David Zee. Finally I should like to thank my wife Gail for her support and for patiently enduring my preoccupation with the computer. xi
Foreword We should welcome the fine contribution of Professor Francis Billson in Strabismus as part of the Fundamentals of Clinical Ophthalmology series. His book reflects his long and thoughtful clinical experience as well as his continued and enthusiastic interest in the basic developmental physiology underlying binocular single vision and the failure of children’s eyes to become aligned normally. Professor Billson and his contributing authors have created a relatively small but effective text, terse, direct and simple in style, that crystallizes the essential considerations needed by the clinician to deal with strabismus in all age groups. This book will prove an excellent learning and teaching tool for ophthalmologists that can be read in independent segments or in its entirety. Not only does it provide a survey that gives cohesiveness to the matters of strabismus, but it will refresh, review and consolidate this clinical area for the reader. Hopefully it will encourage ophthalmic surgeons who have shied away from strabismus problems to deal with them more directly with a renewed enthusiasm. J Raymond Buncic Professor of Ophthalmology Chief of Ophthalmology Hospital for Sick Children University of Toronto Canada xiii
Page 1 and 2: Fundamentals of Clinical Ophthalmol
Page 3 and 4: Fundamentals of Clinical Ophthalmol
Page 5 and 6: © BMJ Books 2003 BMJ Books is an i
Page 7 and 8: CONTENTS Sequelae of strabismus in
Page 10: Preface This book has been written
Page 15: Section I Neurophysiological substr
Page 18 and 19: STRABISMUS dim reflex whereas the m
Page 20 and 21: STRABISMUS compared to the image on
Page 22 and 23: STRABISMUS Chiasm ON LGN ON M LGN P
Page 24 and 25: STRABISMUS Table 2.1 Actions of the
Page 26 and 27: STRABISMUS Table 2.2 Types of eye m
Page 28 and 29: 3 Consequences of breakdown of bino
Page 30 and 31: STRABISMUS Bifoveal fusion Normal B
Page 32 and 33: STRABISMUS • Secondly, in the bin
Page 35 and 36: Section II Strabismus in the decade
Page 37 and 38: 4 Childhood onset of strabismus Chi
Page 39 and 40: CHILDHOOD ONSET OF STRABISMUS indic
Page 41 and 42: CHILDHOOD ONSET OF STRABISMUS (a) (
Page 43 and 44: CHILDHOOD ONSET OF STRABISMUS In ad
Page 45 and 46: CHILDHOOD ONSET OF STRABISMUS may b
Page 47 and 48: CHILDHOOD ONSET OF STRABISMUS retin
Page 51 and 52: CHILDHOOD ONSET OF STRABISMUS Figur
Page 55 and 56: Transient skew deviation CHILDHOOD
Page 57 and 58: CHILDHOOD ONSET OF STRABISMUS add w
Page 59 and 60: CHILDHOOD ONSET OF STRABISMUS Spasm
Page 61 and 62:
5 Adult strabismus Introduction The
Page 63 and 64:
ADULT STRABISMUS Case example An ad
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ADULT STRABISMUS patient presenting
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ADULT STRABISMUS such as in older p
Page 69:
Section III Management of strabismu
Page 72 and 73:
STRABISMUS ● the pattern of the a
Page 74 and 75:
STRABISMUS Figure 6.5 An example of
Page 76 and 77:
STRABISMUS Sensory evaluation - bin
Page 78 and 79:
STRABISMUS Normal R L Normal binocu
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STRABISMUS torsional deviations can
Page 82 and 83:
STRABISMUS (a) (b) (c) (d) Figure 6
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7 Therapy of strabismus Non-surgica
Page 86 and 87:
STRABISMUS of the eye with good vis
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STRABISMUS other forms of non-surgi
Page 90 and 91:
STRABISMUS (a) (b) (c) (d) (e) Figu
Page 92 and 93:
STRABISMUS In attempting to elevate
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STRABISMUS drawn underneath the lat
Page 96 and 97:
STRABISMUS Figure 7.7 Recession wit
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STRABISMUS MR MR LR LR LR LR MR MR
Page 100 and 101:
STRABISMUS overacting in a V patter
Page 102 and 103:
STRABISMUS more persistent diplopia
Page 104 and 105:
STRABISMUS microscope. Inflammation
Page 106 and 107:
STRABISMUS Strabismus Malalignment
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INDEX surgical correction 83-6 see
Page 110 and 111:
INDEX horizontal 54 “horror fusio
Page 112 and 113:
INDEX esotropia 31, 31 monofixation
Page 114 and 115:
INDEX oculocutaneous albinism 43 oc
Page 116:
INDEX vertical muscle surgery 83-6,
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