By Kenneth W. Wright, Yi Ning J. Strube

Strabismus will be devastating to sufferers, but frequently tricky to regard, even for the main pro veteran. The Atlas of Strabismus surgical procedure, Fourth Edition basically and succinctly stocks with the reader techniques and surgical innovations to enhance the care of sufferers, beginning with the easy fundamentals and progressing to extra complex techniques. up to date from the profitable 3rd version, the atlas is designed for resident ophthalmologists and skilled strabismologists alike. whole with enormous quantities of colour illustrations, The Atlas of Strabismus surgical procedure, Fourth Edition covers the administration of quite a lot of strabismus issues, from the fairly basic horizontal strabismus, to the advanced cyclo-vertical deviations.

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Inferior oblique muscle recession, a popular procedure for weakening the inferior oblique muscle, is described in more detail in Chap. 17. Recession of the superior oblique tendon can weaken the superior oblique muscle, but moving the broad insertion of the superior oblique tendon anterior and nasal can produce limitation of depression postoperatively. Principles of Strabismus Surgery A more controlled method of slackening the tendon is a tendon lengthening procedure, the “Wright silicone tendon expander” (see Chap.

If an exotropia persists, treat as discussed above for congenital esotropia. 6 Prognosis Patients with Ciancia’s syndrome often end up with no discernable binocular fusion. When they do achieve fusion, it is peripheral at best, and they rarely (if ever) achieve highgrade stereo acuity. This poor sensory outcome may be due to the very high rate of residual esotropia. 2 Infantile Esotropia Etiology Patients with infantile accommodative esotropia are highly hypermetropic, so they must accommodate an inordinate amount to see clearly.

4 Management Ciancia’s syndrome patients nearly always require surgery. 3 Preoperative Evaluation The examination is the same as for patients with congenital esotropia, discussed above. Because these patients have limited abduction, it is important to document the presence of abduction saccadic eye movements by the doll’s head maneuver or spinning the child. Intact abduction saccadic movements exclude sixth nerve palsy as a cause for limited abduction. Patients with Ciancia’s syndrome will have intact abduction saccadic eye movements, but restriction to abduction because of tight MR muscles.

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