Botulinum augmented surgery for traumatic inferior rectus muscle rupture

This case report aims to present a case with traumatic rupture of the inferior rectus muscle and its management.

A 62-year-old male patient presented with a complaint of double vision following blunt head trauma. Orthoptic examination was performed to assess ocular alignment and motility. Surgical exploration of the inferior bulbar conjunctiva was conducted to identify the extent of the injury.

The patient had limited downgaze with diplopia. Surgical exploration confirmed rupture of the left inferior rectus muscle horizontally as well as vertically. Both ends of the ruptured muscle could be partially found, and the posterior Tenon's capsule was successfully repaired. Botulinum toxin was injected to the left superior rectus muscle.

The findings highlight the importance of detailed orthoptic examination and surgical exploration in diagnosing and managing such complex ocular muscle injuries. Surgical repair combined with botulinum toxin injection presents a viable combined approach for restoring ocular alignment and function in similar cases.