Published by Jitendar P Vij Jaypee Brothers Medical Publishers (P) Ltd Corporate Office 4838/24 Ansari Road, Daryaganj, New Delhi -110002, India, Phone: +91-11-43574357. Fax: +91-11-43574314 Registered Office B-3 EMCA House. 23'23B Ansari Road, Daryaganj. New Delhi -110 002, India Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021 +91-11-23245672, Rel: +91-11-32558559, Fax: +91-11-23276490, +91-11-23245683 e-mail: [email protected], Website: www.jaypeebro1hers.com O ffices in India • Ahmedabad. Phone: Rel: +91 -79-32988717, e-mail: [email protected] • Bengaluru, Phone: Rel: +91-80-32714073. e-mail: [email protected] • Chennai, Phone: Rel: +91-44-32972089, e-mail: [email protected] • Hyderabad, Phone: Rel:+91 -40-32940929. e-mail: [email protected] • Kochi, Phone: +91 -484-2395740, e-mail: [email protected] • Kolkata, Phone: +91-33-22276415, e-mail: [email protected] • Lucknow. Phone: +91 -522-3040554. e-mail: [email protected] • Mumbai, Phone: Rel: +91-22-32926896, e-mail: [email protected] • Nagpur. Phone: Rel: +91-712-3245220, e-mail: [email protected] Overseas Offices • North America Office, USA, Ph: 001-636-6279734, e-mail: [email protected], [email protected] • Central America Office, Panama City, Panama, Ph: 001-507-317-0160. e-mail: [email protected] Website: www.jphmedical.com • Europe Office, UK, Ph: +44 (0)2031708910, e-mail: [email protected] Surgical Techniques in Ophthalmology (Strabismus Surgery) ©2010, Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher. This book has been published in good faith that the material provided by contributors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and editors will not be held responsible for any inadvertent error (s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only. First Edition: 2010 ISBN 978-93-80704-24-1 Typeset af JPBMP typesetting unit Printed at Ajanta Offset & Packagings Ltd., New Delhi Szerzoi jogi vedelem alatt alio anya Contents Section .I: Clinical Strabismus 1. Binocular Vision............................................................................................................................................................. 1 Belquiz A Nassaralla, Joao J Nassaralla Jr (Brazil) 2. Surgical Anatom y..........................................................................................................................................................8 Ewa Oleszczynska Prost (Poland) 3. The Neuroanatomical Basis of Accommodation and Vergence....................................................................... 16 Marcel PM Ten Tusscher (Belgium) ^-Strabism us Examination; An Overview........................................ ........................................................................ 22 AmarAgarwal, Ashok Garg (India) 5. Clinical Features and Adaptations in Strabismus................................................................................................ 38 AmarAgarwal, Ashok Garg (India) 6. Instrumentation in Orthoptic S etu p ........................................................................................................................ 45 Kumar J Doctor, Pooja Deshmukh (India) 7. Amblyopia..................................................................................................................................................................... 62 Shui H Lee (Canada) 8. Rectus Muscles Strengthening Surgery.................................................................................................................72 Ewa Oleszczynska Prost (Poland) 9. Rectus Muscles Weakening Surgery....................................................................................................................... 76 Ewa Oleszczynska Prost (Poland) 1Q. Concomitant Strabisums.......................................................................................................................................... 81 Ewa Oleszczynska Prost (Poland) 11. Management of Paralytic S quint............................................................................................................................123 Rohit Saxena, Swati Phuljhele, Ankur Sinha (India) 12. Superior Oblique Surgery : Indications, Approach and Complications....................................................... 136 Reena Sharma, Pradeep Sharma (India) 13. Management of A and V Patterns in Strabismus............................................................................................... 143 Pradeep Sharma, Harinder Singh Sethi (India) 14. Botulinum Toxin in Strabismus Management.....................................................................................................150 Ewa Oleszczynska Prost (Poland) 15. Management of Nystagmus......................................................................................................................................154 Rohit Saxena, Reena Sharma (India) 16. Intranuclear Disorders of Ocular M otility............................................................................................................ 164 JL Goyal, Sachin Mehta (India) M Edward Wilson, Berdine M Burger (USA) Surgical Techniques in Ophthalmology (Strabismus Surgery) 18. Strabismus Surgery— An Update............................................................................................................................170 Rohit Saxena, Ankur Sinha (India) 19. Special Forms of Strabismus.................................................................................................................................. 182 Rohit Saxena, Swati Phuljheie, Ashish Kakkar (India) 20. Post-traumatic Strabismus.......................................................................................................................................190 В Shukia, P Bhasin (India) Section II: Recent Advances and Innovative Techniques in Strabismus Surgery 21. Newer Surgical Procedures in Strabism us.......................................................................................................... 192 Paromita Datta, Pradeep Sharma (India) 22. Update on Strabismus Surgery in C hildren..........................................................................................................201 Brigitte Pajic-Eggspuehler (Switzerland) 23. Mobius Syndrome (Sequence): Strabismus Surgery.........................................................................................206 LO Ventura, SB Travassos, HC Almeida (Brazil), MT Miller (USA), PA Jorge, BV Ventura (Brazil) 24. New Methods for the Analysis of Ocular Motility: 3D Video Oculography.....................................................213 Carlos Laria, Jorge L Alio (Spain) 25. Sutureless Closure in Strabismus Surgery.......................................................................................................... 237 CS Dhull, Sumit Sachdeva (India) 26. Accommodative Esotropia - An Update................................................................................................................239 Arturo Perez-Arteaga (Mexico) 27. Functional Brain Imaging of Suppression........................................................................................................... 242 Marcel PM Ten Tusscher (Belgium) 28. Managing Amblyopia with Corneal Wavefront-guided Lasik in Children..................................................... 247 Keiki R Mehta, Cyres К Mehta (India) 29. Strategies for Amblyopia: Rehabilitation Orthoptics and Refractive Surgery..............................................257 Roberto Pinelli, Fabrizio Gabas, llaria Sireno (Italy) 30. Double Elevator Palsy (Monocular Elevation Deficit): An U pdate...................................................................264 Sneha Kataria (USA), Sunil Moreker, Mayur Moreker, Rashmi Shukia, Sheetal Kharatmal (India) Index...................................................................................... 267 Copyrighted material Section I: Clinical Strabismus Chapter Binocular Vision Belquiz A Nassaralla, Joao J Nassaralla Jr (Brazil) Binocular vision is the integration of the sensation superimposition of dissimilar objects viewed by the two produced by the light stimulus in each eye into a unified eyes. An example of this lowest grade of binocularity is perception. It is an acquired, conditioned reflex, which the ability to perceive a lion in a cage (Fig. 1) when viewing has some requisites for its development: the cage with one eye and the lion with the other through 1. There must be proper fixation with each eye. The a synoptophore (Fig. 2). muscles controlling the movements of each eye must Simultaneous perception of differing binocular function normally and turn both eyes in such a images is limited by the phenomenon of rimlry, which manner that the object of regard is fixated by may exclude from visual awareness part of the input from corresponding retinal areas, e.g. the two foveas. one fovea or the other when the two differ sufficiently. 2. The visual fields of the two eyes must overlap to a If a person looks into a stereoscope at two dissimilar large extent. targets with overlapping nonfusible contours, first one 3. Approximately