Botulinum augmented surgery for traumatic inferior rectus muscle rupture.

Area of Science:

• Ophthalmology
• Trauma Surgery

Background:

• Traumatic rupture of extraocular muscles, particularly the inferior rectus, is a rare but serious injury.
• Blunt head trauma can lead to complex ocular motility disturbances, including diplopia and limited eye movements.

Purpose of the Study:

• To present a case of traumatic inferior rectus muscle rupture.
• To describe the diagnostic and management strategies employed.
• To evaluate the efficacy of surgical repair and adjunctive botulinum toxin therapy.

Main Methods:

• A 62-year-old male with diplopia post-blunt head trauma underwent comprehensive orthoptic examination.
• Surgical exploration of the inferior bulbar conjunctiva identified a horizontally and vertically ruptured inferior rectus muscle.
• Repair of the posterior Tenon's capsule and injection of botulinum toxin into the superior rectus muscle were performed.

Main Results:

• The patient presented with limited downgaze and diplopia.
• Surgical findings confirmed a complete rupture of the inferior rectus muscle.
• Post-operative management involved successful Tenon's capsule repair and botulinum toxin injection.

Conclusions:

• Detailed orthoptic examination and surgical exploration are crucial for diagnosing complex ocular muscle injuries.
• Combined surgical repair and botulinum toxin injection offer a viable approach for restoring ocular alignment and function in traumatic muscle ruptures.