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[Synergistic divergence--case report].

Ioana Daniela Boricean

    Oftalmologia (Bucharest, Romania : 1990)
    |May 22, 2014
    PubMed
    Summary

    This case study details a 12-year-old girl with congenital exotropia (XT) in her left eye, who underwent multiple surgeries. Post-operative orthotropia was achieved, satisfying the patient and family aesthetically.

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    Area of Science:

    • Ophthalmology
    • Strabismus Surgery

    Background:

    • Congenital exotropia (XT) is a common strabismus condition.
    • Recurrent XT often requires multiple surgical interventions.

    Observation:

    • A 12-year-old female presented with a history of congenital XT in the left eye (OS) since 16 months old, with five prior OS surgeries.
    • Current presentation included a right face turn, 60 PD XT in OS (with left hypertropia) in primary gaze, worsening in dextroversion (>80 PD) and improving in levoversion (40 PD).
    • OS demonstrated abolished adduction and limited depression; OD was normal. Simultaneous abduction of both eyes occurred during dextroversion. Binocular single vision was absent.

    Findings:

    • Surgical intervention involving large lateral recti recessions on both eyes was performed.
    • Postoperatively, orthotropia was achieved in the primary position.
    • Simultaneous abduction persisted, but the patient and family reported high satisfaction with the cosmetic outcome.

    Implications:

    • Large recessions can achieve orthotropia in complex, recurrent exotropia cases.
    • Persistent simultaneous abduction may not preclude patient satisfaction.
    • Further management may be needed for residual motility issues.

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