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Role of the vertical muscles in horizontal deviations
Transactions of the Ophthalmological Societies of the United Kingdom
|April 1, 1977
Summary
Horizontal muscle surgery for non-paralytic squint can lead to vertical deviations and loss of binocular vision. Early vertical deviation may be a key factor in squint development and requires careful examination.
Area of Science:
- Ophthalmology
- Strabismus Research
- Ocular Motility
Background:
- Horizontal muscle surgery for non-paralytic squint often results in residual vertical deviation and loss of binocular vision.
- The presence of vertical deviation, sometimes subtle, is frequently observed post-operatively and may be congenital.
Purpose of the Study:
- To investigate the role of pre-existing vertical deviations in the etiology of non-paralytic squint.
- To explore the influence of cyclotropia and ocular torsion on squint mechanisms.
Main Methods:
- Observational study analyzing cases of non-paralytic squint post-horizontal muscle surgery.
- Clinical examination focusing on eye movements, including extremes of elevation and depression, to detect vertical deviations.
- Review of literature and established theories on cyclotropia and ocular motility.
Main Results:
- A significant number of patients developed residual vertical deviation and lost binocular vision after horizontal muscle surgery.
- Associated vertical deviation is often present from onset and can be missed if not specifically examined for at extremes of gaze.
Conclusions:
- Pre-existing vertical deviations may be a significant factor in the mechanism of non-paralytic squint.
- Cyclotropia, considered a third dimension of ocular motility, is important in achieving binocular vision and aligning retinal points.