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Management of Comitant Convergent Strabismus

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Hossein Mirzaie
Hossein Mirzaie

The document discusses the nature and management of comitant convergent and divergent strabismus. It covers factors to consider in evaluation such as age, angle of strabismus, and sensory adaptations. For management of convergent strabismus, it discusses approaches for fully accommodative esotropia, partially accommodative esotropia, convergence excess, and non-refractive esotropias. For divergent strabismus, it discusses divergence excess, near exophoria, and constant exotropia. Surgical correction is usually needed for large angle or non-accommodative deviations.

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Grand Rounds
NATURE AND MANAGEMENT OF COMITANT CONVERGENT STRABISMUS ,[object Object]
Evaluation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Age ,[object Object],[object Object],[object Object]
Age at Onset ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Type of Strabismus : ,[object Object],[object Object]
Angle of Strabismus ,[object Object],[object Object],[object Object],[object Object],[object Object]
Depth of Sensory Adaptations ,[object Object]
Cooperation of Patient and Parent ,[object Object],[object Object]
Refractive Esotropias ,[object Object],[object Object],[object Object]
Fully Accommodative Esotropia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object]
Criteria: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Method ,[object Object]
Method ,[object Object],[object Object],[object Object]
Partially Accommodative Esotropia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object]
Convergence Excess ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object]
Non-refractive Esotropias
Constant: ,[object Object],[object Object],[object Object]
Intermittent:
Near esotropia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Distance Esotropia ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cyclic Esotropia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Consecutive Esotropia ,[object Object],[object Object]
Symptomatic (secondary) esotropia ,[object Object]
The management of non-refractive SOT is almost always surgical. ,[object Object],[object Object],[object Object]
Essential Infantile Esotropia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nystagmus Blocking (or compensation) Syndrome ,[object Object],[object Object]
Accommodative Infantile Esotropia ,[object Object],[object Object],[object Object],[object Object],[object Object]
Sixth Nerve Palsy ,[object Object],[object Object]
Nature and Management of Comitant Divergent Strabismus
Divergence Excess ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object]
Near Exophoria (Convergence Insufficiency) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Constant (Basic) Exotropia ,[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object]
Consectutive Exotropia ,[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object]
Symptomatic (Secondary) Exotropia ,[object Object],[object Object]
Onset of Exotropia before 1 year old ,[object Object],[object Object],[object Object],[object Object]
Vertical Heterophoria Hyperphoria ,[object Object],[object Object]
Two types ,[object Object],[object Object]
Secondary hyperphoria ,[object Object],[object Object],[object Object]
Primary/True hyperphoria – ,[object Object],[object Object]
Investigation
Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Dissociated Vertical Deviation (alternating sursumduction) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Dissociated Vertical Deviation (alternating sursumduction) Stidwell, 1997
A and V Patterns ,[object Object],[object Object]
Convergence ,[object Object],[object Object]
Divergence ,[object Object],[object Object]
The aetiology of A and V patterns ,[object Object],[object Object]
Cyclodeviations ,[object Object],[object Object],[object Object]
Pseudostrabismus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Management of Comitant Convergent Strabismus

Notas del editor

  1. The condition in which the patient sees not much and the practitioner nothing at all… ! It is always (or almost always) associated with strab, aniso or form deprivation in early life. Diagnosed when there reduced letter acuity, absence of pathology and when any ametropia is corrected. The results of pyschophysical studies & electrophysiological investigations suggest little primary retinal or LGN abnormality. Instead, the most profound effects of the amblyopic process are found in the striate cortex.