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COMMENTARY
Year : 2020  |  Volume : 68  |  Issue : 5  |  Page : 926-927

Commentary: Anomalous extraocular muscles in Crouzon syndrome with V-pattern exotropia


Command Hospital, Bangalore, Karnataka, India

Date of Web Publication20-Apr-2020

Correspondence Address:
Dr. Anirudh Singh
Department of Ophthalmology, Command Hospital Air Force, Airport Road, Agram Post, Bangalore - 560 007, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1993_19

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How to cite this article:
Singh A. Commentary: Anomalous extraocular muscles in Crouzon syndrome with V-pattern exotropia. Indian J Ophthalmol 2020;68:926-7

How to cite this URL:
Singh A. Commentary: Anomalous extraocular muscles in Crouzon syndrome with V-pattern exotropia. Indian J Ophthalmol [serial online] 2020 [cited 2020 May 26];68:926-7. Available from: http://www.ijo.in/text.asp?2020/68/5/926/282950



Crouzon syndrome is a complex craniosynostoses with hypertelorism, shallow orbits, and prominent globes.[1],[2] Premature closure of the sutures (coronal, sagittal, and lambdoid) results in deformation of the head and orbit. This is often accompanied with anomalies of extraocular muscles (including hypoplasia, aplasia, etc) leading to a complicated strabismus.[3],[4],[5] In this regard, a detailed analysis of EOM anatomy in MRI is helpful and should be considered in all cases.

Each surgical plan is dependent on the individual patient's extraocular muscle anatomy and is highly unpredictable. Despite the best efforts in localizing the muscle anatomy on neuroimaging it is still possible to have surgical surprise.[6] The surgeon should be prepared in all such cases to handle the intraoperative challenges in the form of muscle transplantation and resurgery options. A detailed consent should be obtained from the patient and all the surgical options discussed with either the patient or his/her parents (in case of minors).

The surgical results may not always match up to the expectations; however, they do improve the quality of life for both children and their families by improving the functional fields of gaze.



 
  References Top

1.
Diamond GR, Katowitz JA, Whitaker LA, Quinn GE, Schaffer DB. Variations in extraocular muscle number and structure in craniofacial dysostosis. Br J Ophthalmol 1980;64:416-8.  Back to cited text no. 1
    
2.
Miller MT. Ocular abnormalities in craniofacial malformations. Int Ophthalmol Clin 1984;24:143-63.  Back to cited text no. 2
    
3.
Morax S. Oculo-motor disorders in craniofacial malformations. J Maxillofac Surg 1984;12:1-10.  Back to cited text no. 3
    
4.
Carruthers JD. Strabismus in craniofacial dysostosis. Graefes Arch Clin Exp Ophthalmol 1988;226:230-4.  Back to cited text no. 4
    
5.
Coats DK, Paysse EA, Stager DR. Surgical management of V-pattern strabismus and oblique dysfunction in craniofacial dysostosis. J AAPOS 2000;4:338-42.  Back to cited text no. 5
    
6.
Singh A, Sharma A, Sharma P. Congenital bilateral aplasia of medial recti in a family. JAMA Ophthalmol 2013;131:798-800.  Back to cited text no. 6
    




 

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