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Extra-large V pattern in exotropia: a rare case and its management.
Shailja Tibrewal1, Manasvini Sharma1, Soveeta Rath1
1Department of Pediatric Ophthalmology and Strabismus, Dr Shroff Charity Eye Hospital , New Delhi.
Strabismus
|January 18, 2020
Summary
This study details a rare case of extra-large V pattern strabismus managed with combined surgical procedures. Successful treatment improved eye alignment, binocularity, and stereopsis, highlighting the need for tailored surgical approaches.
Area of Science:
- Ophthalmology
- Strabismus Surgery
Background:
- V pattern strabismus involves increased divergence in up-gaze compared to down-gaze, often correctable with single procedures.
- Extra-large V patterns are uncommon and may require complex management strategies.
Observation:
- A rare case presented with an extra-large V pattern (>60 Prism Diopters) and significant exotropia (70 PD).
- Ocular motility showed over-elevation in adduction and extreme divergence in up-gaze, with ex-cyclotorsion of both globes.
Findings:
- The V pattern was surgically managed using bilateral inferior oblique muscle recession and lateral rectus muscle upshift.
- Exotropia was treated with bilateral lateral rectus recession and right medial rectus resection.
- Post-surgery, both exodeviation and V pattern reduced to <10 PD, with decreased ex-cyclotorsion and improved stereopsis.
Implications:
- Complex strabismus cases, like this extra-large V pattern, may necessitate a combination of surgical techniques.
- Combined procedures can achieve favorable motor and sensory outcomes in challenging strabismus presentations.
- This case underscores the importance of individualized surgical planning for V pattern strabismus.
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