The Effect of Horizontal Extraocular Muscle Surgery on the Heimann-Bielschowsky Phenomenon

We report the effect of horizontal extraocular muscle surgery of Heimann-Bielshowsky phenomenon. A 52-year-old woman complained of binocular diplopia for a few months. In 2000, she underwent extracapsular cataract extraction with intraocular lens implantation in the right eye. After surgery, the diplopia persisted and developed further. She showed an esodeviation of 60 prism dioptres at near fixation and distance fixation. Cortical opacity and nucleus sclerosis were observed in the left lens, and phacoemulsification with intraocular lens implantation was performed in the left eye in October 2011. After cataract surgery, the patient suffered from oscillopsia and diplopia. Examination revealed unilateral coarse, slow, pendular vertical oscillations in the right eye and an esodeviation of 45 prism dioptres and a right hypodeviation of 8 prism dioptres, which were observed before the surgery. We performed a medial rectus muscle 6 mm recession and lateral rectus muscle 7 mm resection surgery on the right eye. After the operation, the oscillations disappeared and diplopia greatly improved. Moreover, the patient no longer complained of oscillopsia. We conclude that surgery performed on horizontal extraocular muscles could be an effective treatment for Heimann-Bielschowsky phenomenon also.