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Convergent strabismus fixus without high myopia.

Teena M Mendonca1, Shailja Tiberwala1, Virender Sachdeva2

  • 1Jasti V Ramanamma Children's Eye Care Centre, L V Prasad Eye Institute, Hyderabad, India.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
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Summary

This case study presents progressive esotropia in an adult, mimicking heavy eye syndrome without high myopia. Surgical intervention resulted in a significant shift towards exotropia.

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Area of Science:

  • Ophthalmology
  • Strabismology

Background:

  • Convergent strabismus fixus is a rare condition characterized by inward turning of the eyes.
  • Progressive esotropia, particularly in adulthood, necessitates thorough investigation into underlying causes.

Observation:

  • A 37-year-old woman presented with a >140Δ esotropia since childhood, with reduced visual acuity and limited abduction in the left eye.
  • CT scans revealed abnormal positioning of the superior rectus and lateral rectus muscles in the left eye.

Findings:

  • Surgical correction involved medial rectus recession and superior rectus-lateral rectus loop myopexy.
  • Postoperatively, the patient developed an 8Δ exotropia, indicating a successful, albeit overcorrected, alignment change.

Implications:

  • This case suggests that progressive esotropia, resembling "heavy eye syndrome," can occur without high myopia.
  • Understanding atypical muscle positioning is crucial for managing complex strabismus cases.