Paralytic strabismus

Paralytic strabismus ,[object Object]

this does not aid in the diagnosis of the affected muscle in paretic situation. ,[object Object],[object Object]

Terms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hering’s Law of Equal Innervation ,[object Object],[object Object],[object Object]

Sheringtons Law of Reciprocal Innervation ,[object Object],[object Object],[object Object]

Sequelae of Ocular Muscle Palsy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Overaction of the contralateral synergist ,[object Object],[object Object],[object Object],[object Object]

Overaction of the ipsilateral (direct) antagonist ,[object Object],[object Object],[object Object]

Underaction of the antagonist of the contralateral synergist (contalateral antagonist) ,[object Object],[object Object]

Overaction of the ipsilateral synergist ,[object Object]

For example in paralysis of the right superior rectus ,[object Object],[object Object],[object Object],[object Object],[object Object]

ANATOMICAL CONSIDERATIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Superior Rectus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

In primary position muscle plane of the SR forms angle 23°with optical axis. In this position SR Elevates the globe. Secondary Actions intorsion and adduction

In 23° abduction, SR complete Elevator, muscle plane coincides with optical axis

Superior Oblique ,[object Object],[object Object],[object Object],[object Object],[object Object]

Eye in primary position Muscle plane SO forms angle 54° with optical axis. Action is intorsion Secondary actions abduction and depression RE

When globe adducted 54°, Optical axis and muscle plane coincide, SO is pure depressor RE

RE In abduction SO is primarily an intortor

Inferior Rectus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Inferior Oblique ,[object Object],[object Object],[object Object],[object Object],[object Object]

For right eye read from the top For left eye read from the bottom

Rule for the secondary actions of the vertical muscles ,[object Object]

INCOMITANT STRABISMUS : CLASSIFICATION AND INVESTIGATION ,[object Object]

Classification ,[object Object],[object Object],[object Object],[object Object],[object Object]

Congenital ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Acquired ,[object Object],[object Object],[object Object],[object Object],[object Object]

INVESTIGATION OF INCOMITANCY ,[object Object],[object Object],[object Object],[object Object],[object Object]

History and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

General observation of the patient ,[object Object]

Abnormal head posture ,[object Object],[object Object],[object Object],[object Object],[object Object]

Components ,[object Object],[object Object],[object Object]

Face turn – to the left or right. ,[object Object],[object Object]

Chin elevation or depression ,[object Object],[object Object],[object Object]

Head tilt : occurs for 2 reasons ,[object Object],[object Object],[object Object]

Head tilt : occurs for 2 reasons ,[object Object],[object Object],[object Object],[object Object],[object Object]

Cover Test with and without AHP

Cover Test: comparison of deviation with each eye fixing ,[object Object],[object Object],[object Object],[object Object],[object Object]

Cover Test: comparison of deviation with each eye fixing ,[object Object]

Motility – check ,[object Object],[object Object],[object Object],[object Object],[object Object]

Motility – check ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

3 step technique (more reliable in fairly recent paresis) ,[object Object],[object Object]

3 step technique (more reliable in fairly recent paresis) ,[object Object],[object Object],[object Object],[object Object]

Hess Screen Plots ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Lateral Rectus ,[object Object],[object Object],[object Object]

Medial rectus ,[object Object],[object Object],[object Object],[object Object]

Superior Rectus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Inferior Rectus ,[object Object],[object Object],[object Object],[object Object],[object Object]

Inferior Oblique ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Superior Oblique ,[object Object],[object Object],[object Object],[object Object]

Paralytic strabismus

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Paralytic strabismus

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