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[Bilateral progressive supra-fixing eyes with congenital misinsertion of inferior rectus muscles--a case report]
1Department of Ophthalmology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
Background:
We report on a rare case with misinsertion of the inferior rectus muscles, that showed bilateral progressive supra-fixing eyes.
Case:
A 68-year-old woman showed bilateral progressive supra-fixing eyes with low vision that was caused by microcorneas and retionochoroidal atrophy. Passive infraduction was restricted bilaterally, but the right inferior rectus muscle was innervated normally. Magnytic resonance imaging(MRI) demonstrated nasal misposition of bilateral inferior rectus muscles. The patient's eye position was improved after combined transposition of the inferior rectus muscles that were misinserted nasally to the inferior poles of the eyes and superior rectus muscle recession, without any complications.
Conclusion:
A dysfunction of bilateral depressor muscles and low vision may cause this condition. Accurate diagnosis with MRI and correction of the affected muscles to the normal anatomical position produces satisfying results in such cases.
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