Esotropia associated with high myopia.

Area of Science:

• Ophthalmology
• Strabismology
• Medical Imaging

Background:

• High myopia is associated with a specific type of esotropia, termed heavy eye syndrome.
• This condition presents as a rare restrictive strabismus requiring specialized management.
• Understanding the pathophysiology is crucial for effective treatment.

Purpose of the Study:

• To describe the pathophysiology of esotropia in high myopia (heavy eye syndrome).
• To discuss preoperative evaluation strategies for affected patients.
• To review surgical options for managing this complex strabismus.

Main Methods:

• Review of numerous studies investigating the etiology of esotropia in high myopia.
• Analysis of orbital imaging findings, including muscle displacement.
• Evaluation of surgical techniques, specifically loop myopexy.

Main Results:

• Orbital imaging reveals nasal displacement of the superior rectus and inferior displacement of the lateral rectus muscles.
• Traditional resection-recession surgery is often ineffective due to altered muscle paths.
• Loop myopexy, with or without medial rectus recession, shows promise without scleral fixation sutures.

Conclusions:

• Heavy eye syndrome is a rare restrictive strabismus requiring careful preoperative diagnosis.
• Posterior globe prolapse with superior and lateral rectus muscle displacement characterizes the condition.
• Loop myopexy is a well-tolerated and effective treatment for heavy eye syndrome.