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Strabismus

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Strabismus is a condition of misalignment of the eyes, it occurs in 2-5% of the population yet in more that 80% of the patients with Apert syndrome. Strabismus can be horizontal, vertical or torsional. There are different types of strabismus, a combination is also possible (figure1). The V-pattern is an exotropia on upgaze, diminishing in downgaze. This strabismus pattern is associated with an overactive m. obliques inferior, with a possible underaction of the m. obliques superior. This can lead to hypertropia which will worsen in adduction.

The eye has 6 extraoculair muscles:
• M. rectus inferior innervation by n. oculimotorius
• M. rectus medius innervation by n. oculimotorius
• M. rectus superior innervation by n. oculimotorius
• M. rectus lateralis innervation by n. abducens
• M. obliquus inferior innervation by n. oculomotorius
• M. obliquus superior innervation by n. trochlearis

Two major principles in order to understand the mechanism of strabismus:
• Hering’s law of equal innervation: to ensure coordinated binocular eye movements both against muscles in both eyes must receive equal innervation.
• Serrington’s law of …show more content…
Treatment of strabismus involves prescribing necessary glasses, orthoptics, optometric vision therapy and/or strabismus surgery. The aim of this surgery is to loosen or tighten the eye muscles (figure 2), so the alignment of the eyes change relatively to each other. The muscles are covered by a thin layer of transparent conjunctiva and are attached to the sclera. After an incision in the conjunctiva, the surgeon can access the eye muscle. Then there is recession or resections. Recession: the muscle will be cut from the eye and will be reattached further back, which weakens the muscle function. Resection: the muscle will be cut out of the eye. After removing a section from the muscle, it will be reattached at the same place. This will strengthen the

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