The ocular rotational power which a rectus muscle exerts is a product of the muscle's force and the length of the lever arm between the muscle's tangential point of contact with the globe and the centre of rotation of the eye. A recession operation weakens a rectus muscle because the distance between the muscle's origin at the orbital apex and its insertion into the surface of the globe is decreased, so that the muscle becomes slack. Provided that the recession does not exceed the conventional maximum (Table I), the length of the lever arm is not reduced. Even when the eye moves into the field of action of the recessed muscle, the length of the rotational lever arm remains unchanged as the tangential point of muscle action is still on the surface of the globe. If the muscle is over- recessed, not only does it become very slack but the effective lever arm is reduced in length and mechanical restriction of movement ensues. The weakening effect of a conventional recession operation is therefore approximately the same in all directions of gaze in which the muscle is active (Figs. 1 and 2). Table I Maximum recession possible without limiting ocular motility.

/pdf/faden-operation-posterior-fixation-sutures-2hzpfh7sg3.pdf

Faden operation (posterior fixation sutures).

Early-onset estropia comprises a heterogenous group of conditions. It is very important that all the features of the strabismus should be determined from the very earliest stage. Only then can appropriate treatment and an accurate prognosis be given and the outcome of management evaluated adequately. Key words: esotropia, accommodative, V-pattern, congenital, infantile, small-angle.

Some aspects of early-onset esotropia

Infantile esotropias include early-onset (up to 6–8 months of age) and later onset (between 6–8 and 30–36 months of age) forms. Both groups having potentially abnormal sensorial functions, that is, no, or insufficient experience of, normal binocular single vision. Surgical management is one part of the treatment for infantile esotropia. The primary goal is to obtain the smallest possible stable residual angle in concordance with the abnormal sensorial potentialities, while retaining long-term stability, by means of the least number of surgeries. After correction of any ametropia, prevention or treatment of any functional amblyopia, and preoperative preparation, the choice of surgical strategy depends on the components of the deviation – the basic angle after sufficient wearing of the full optical correction and angle variability. Determining factors are the target angle and intraoperative data, which indicate any imbalance of passive muscles forces under anesthesia and the differential of muscle extensibi...

Surgical management in infantile esotropia

Claude Speeg-Schatz †

It would not make sense to present the dry results without an idea of the conceptions behind. For this reason we shall introduce this communication with a few remarks on technical and indicational problems.

Results of the Fadenoperation in Alternating Convergent Strabismus of the Congenital Type

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Results of the Fadenoperation in Alternating Convergent Strabismus of the Congenital Type