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      Orbital Causes of Incomitant Strabismus

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          Abstract

          Strabismus may result from abnormal innervation, structure, or function of the extraocular muscles. Abnormalities of the orbital bones or masses within the orbit may also cause strabismus due to indirect effects on the extraocular muscles. This paper reviews some disorders of the orbit that are associated with strabismus, including craniofacial malformations, orbital masses, trauma, and anomalous orbital structures.

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          Ophthalmic sequelae of Crouzon syndrome.

          Dinesh Selva, L. Gray, Peter Anderson … (2005)
          To document the frequency of ophthalmic sequelae in patients with Crouzon syndrome before the influence of craniofacial surgery. Retrospective observational case series. Seventy-one consecutive patients with a clinical diagnosis of Crouzon syndrome assessed before craniofacial or ophthalmic surgery at the Australian Craniofacial Unit between 1984 and 2000. Review of clinical records with documentation of patient age, gender, visual acuity, refractive error, diagnosis of amblyopia, squint, eye movement dysfunction, nystagmus, fundus examination, examination of the anterior segment, interpupillary distance, and intercanthal distance. The frequency of ophthalmic signs and visual impairment, defined as a visual acuity of 6/12 or less. Visual impairment in at least 1 eye occurred in 35% of patients and was bilateral in 9%. The most common cause of visual impairment was amblyopia, which was present in 21% of patients, followed by optic atrophy in 7%. Ametropia occurred in 77% of patients; 57% had hypermetropia of > or =+2 diopters (D) and 20% had myopia of > or =-0.5 D. Strabismus occurred in 39% of patients. Although exposure keratopathy was observed in 15% of patients, this complication was well managed and caused no reduction in visual acuity. Early detection to reduce amblyopia by correction of refractive errors, timely treatment of strabismus, and patching should be a priority for ophthalmologists and a goal of the craniofacial teams managing patients with Crouzon syndrome. Optic atrophy remains an important cause of visual impairment in these patients before decompressive craniectomy.
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            Pivotal role of orbital connective tissues in binocular alignment and strabismus: the Friedenwald lecture.

            J Demer (2004)
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              Inflammatory disorders of the orbit in childhood: a case series.

              Samuel Zhang, Caroline Bélanger, Frances T. Yen … (2010)
              To describe a series of cases of orbital inflammatory disorders in children. Retrospective case series. The medical records of pediatric patients diagnosed with orbital inflammation between September 1, 2002, and December 31, 2008, at Texas Children's Hospital were reviewed. Data collected included age at presentation, final diagnosis, treatment, workup and evaluation, need for biopsy and biopsy results, and involvement of lacrimal gland and muscles. Twelve cases were identified. Six cases were males and 6 were females with age at presentation ranging from 1.3 to 16.2 years (mean, 11.9 years). The most common presentation was lacrimal gland enlargement, which was bilateral in 3 cases. Other common presenting signs were proptosis, extraocular motility limitation, and pain on eye movement. Half of our patients had systemic complaints at presentation, the most common of which was fever. Four patients were diagnosed as having a systemic cause and 2 of these patients had systemic symptoms. Idiopathic orbital inflammatory conditions in children are uncommon, but can be associated with systemic conditions. Patients typically have lacrimal gland involvement, pain with eye movement, proptosis, and motility deficits at presentation. Bilateral cases may have a higher incidence of systemic disease. Copyright © 2010 Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Middle East Afr J Ophthalmol
                Journal ID (iso-abbrev): Middle East Afr J Ophthalmol
                Journal ID (publisher-id): MEAJO
                Title: Middle East African Journal of Ophthalmology
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 0974-9233
                ISSN (Electronic): 0975-1599
                Publication date (Print): Jul-Sep 2015
                Volume: 22
                Issue: 3
                Pages: 286-291
                Affiliations
                [1]Departments of Ophthalmology and Visual Sciences and Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO, USA
                Author notes
                Corresponding Author: Dr. Gregg T. Lueder, St. Louis Children's Hospital (Rm 2s89), Washington University School of Medicine, One Children's Place, St. Louis, MO – 63110, USA. E-mail: Lueder@ 123456vision.wustl.edu
                Article
                Publisher ID: MEAJO-22-286
                DOI: 10.4103/0974-9233.159714
                PMC ID: 4502170
                PubMed ID: 26180465
                SO-VID: 221f4b17-238c-4cd0-b75c-8a25c05689e0
                Copyright © Copyright: © Middle East African Journal of Ophthalmology
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Incomitant Strabismus Update

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: extraocular muscles,orbit,strabismus
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: extraocular muscles, orbit, strabismus

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