By Edward L. Raab, MD, JD

Examines the scientific beneficial properties, analysis and therapy of esodeviations and exodeviations, horizontal and vertical deviations, amblyopia and unique types of strabismus. Discusses the total variety of pediatric ocular issues, extraocular muscle anatomy, motor and sensory body structure and the way to set up rapport with kids in the course of an ocular exam. includes a number of photos, together with colour images. lately revised 2010 2011.

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Extra resources for 2011-2012 Basic and Clinical Science Course, Section 6: Pediatric Ophthalomology and Strabismus (Basic & Clinical Science Course)

Sample text

Clinically, the consequences of tissue entrapment in blowout fractures and post-retrobulbar hemorrh age fibrosis of delicate fibrous septa illustrate the intense fibrous connections throughout the orbit. Adipose Tissue The eye is supported and cushioned in the orbit by a large amount of fatty tissue. External to the muscle cone, fatty tissue comes forward wi th the rectus muscles, stopping about 10 mm from the lim bus. Fatty tiss ue is also present inside the muscle cone, kept away from the sclera by the Tenon capsule (see Fig 2-5).

The vergence system cont ro ls d isconjugate eye rn ovement, as in co nve rgence o r dive rge nce. Supranuclear co nt rol of ve rgence eye movements is not yet fuU y und erstood. T he l1otloptic reflex systems integrate eye movemen ts and bod y movements. The mos t clinicall y impo rtant of th ese systems is th e labyrinthine reflex system, whi ch in vo lves the semicircul ar canals of the inner ears. O ther, less im portant, systems involve th e utri cle and saccul e of the inner ears. The cervical, or neck, rece ptors also p rovide in put for th is nonoptic refl ex control.

However, fusional convergence movements maintain si milar retinal images on corresponding retinal areas, and the eyes are observed to converge. This response is called fusional convergence. Motor fusio n may be thought of as a diplopia avoidance mechanism and is the exclusive function of the extrafovea l retinal periphery. Fusional vergence am plitudes can be measured with rotary prisms, by major haploscopes, and by other devices. Representative normal values are give n in Table 4- 1. Fusional ve rgences are also discussed in Chapter 6.

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