Juniper
Publishers- JOJ Ophthalmology
Abstract
6 months un identical twins were seen by me in 2002
at qatif central hospital eastern province ks a with parents having
noticed bill alternating inward ocular deviation since 2 monthsft
normally delivered twins no history of exposure to oxygen birth trauma
convulsions jaundice fever or any other cong ocular disorder like 1
sclera cornea 2 keratitis corneal dystophy peters corneal anomaly or
limbal corneal dermoid on exam both twins dhad bil alt 15 degrees
esotropia no limitation of ocular movements 2 no turning of head towards
the direction of paralysed muscle 3 no diplopia 4 no abnormal head
posture or false orientation under sedation mydriatic refraction and
fundus examination was done ref was equal in both eyes in both eyes so
were the normal fundii key words esotropia is inward ocular deviation 2
expotropia is outward ocular deviatin 3 hetrophoria is latenr ocular
deviatin 4 infantile is age from birth to 3 years .
Introduction
squint is a common ocular disorder nowadays due to
abuse of playing games on mobiles and i pads incidence of ocular
deviation has increased recently I saw twins of 6 years of age parents
complained that one twin had left eye ocular deviation since 3 months as
this twin was constantly playing video games on exam this twin had plus
2d cylinder 130 axis other twin as he was not playing games was normal
squints can be 1 esotopia 2 esotropia 3 heterotopias 4 paralytic 5 non
paralytic 6 accommodative 7 non accommodative 8 pseudo squint in those
who have broad bridge of nose epicanthal folds and wide inter canthal
distance results of bill alt infantile esotropia with bill 5mm medial
rectii recessions are very satisfactory both 1 from correction of angle
of squint and reaction of eye which is minimal [1].
Discussion
Bill alt esotropia presents as 1 crossed fixation 2
uncrossed fixation 3 over action of inf oblique 4 a v patern 5 broad
angle 6 covering the dominant eye will make p child to cry so after all
investigations under g a both twins were operated under g a exposure of
eye done with eye speculmm rotation of eye ensyred with 6 zero silk
sutures 5mm recessions of medial rectii one and position of muscle
secured on sclera using 6 zero vicoryl suture closure of conjuctival
wound done with 8 zero silk sures next day children had very
satisfactory correction of angle of deviation and most important thing
was that eye reaction was minimal
Conclusion
Bill m rectii recessions is a very satisfactory
procedure for cases of bill alt infantile esotropia as we do not cut
muscle that is resection so the eye reaction is minimal and secondly
correction of eye deviation is good I did this procedure in 2002 even
today same procedures is done even after 17 years due to satisfactory
modality of this surgical procedure however some complications r seen
like 1 under correction 2 over action of inf oblique 3 amblyopia 4 d v d
dissociated vertical deviation 5 accommodative element in my cases more
than 1 buyers follow up of twins was normal.
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