Strabismus and Eye Muscle Surgery - Pediatric …：斜视、眼肌手术-小儿….ppt

Initially the baby has a “button nose, with a very flat nasal bridge. The baby lids cover the medial white part of the eyes causing the appearance of the eyes being crossed. As the nasal bridge develops and grows forward it will drag the medial portion of the lids inward reducing the appearance of the eyes being crossed. 3 Pseudo ET G.Vicente,MD Initially the baby has a “button nose, with a very flat nasal bridge. The baby lids cover the medial white part of the eyes causing the appearance of the eyes being crossed. As the nasal bridge develops and grows forward it will drag the medial portion of the lids inward reducing the appearance of the eyes being crossed. 4 Pseudo ET G.Vicente,MD Exotropia Intermittent is very common How symptomatic are they? Make sure they have BCVA glasses Diplopia? Often familial, so what? Dad had it too. “What hump?” Intermittent exotropia can breakdown over time, check serial stereo. If worsening think surgery. Most common time of pediatric surgery is 7 years old. Can the pt converge? Convergence insufficiency Seen in kids who have trouble reading Adults with Parkinson’s disease Consider Convergence exercises by a pediatric optometrist, or at home exercises with special software Decreasing add in bifocals to extend reading distance (holding reading material further away) Prisms, may used at times. Nomenclature Orthorphoria o Esophoria E Esotropia ET Intermittent Esotropia E(T) Exophoria X Exotropia XT Intermittent Exotropia X(T) At near X(T)’ Right Hypertropia RHT convergent divergent G.Vicente,MD Cover – Uncover test Orthophoria, normal No complaints, asymptomatic G.Vicente,MD G.Vicente,MD Cover – Uncover test Esophoria, abnormal, common Only seen when eye is covered Often asymptomatic, no complaints Note OS does not move. G.Vicente,MD Cover – Uncover test Exophoria, abnormal, common Only seen when eye is covered Note OS does not move Often asymptomatic, no complaints. G.Vicente,MD Alternate cover test Remember to a