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COMMENTARY |
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Year : 2020 | Volume
: 68
| Issue : 5 | Page : 926-927 |
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Commentary: Anomalous extraocular muscles in Crouzon syndrome with V-pattern exotropia
Anirudh Singh
Command Hospital, Bangalore, Karnataka, India
Date of Web Publication | 20-Apr-2020 |
Correspondence Address: Dr. Anirudh Singh Department of Ophthalmology, Command Hospital Air Force, Airport Road, Agram Post, Bangalore - 560 007, Karnataka India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/ijo.IJO_1993_19
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 |
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 | | |
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. |
2. | Miller MT. Ocular abnormalities in craniofacial malformations. Int Ophthalmol Clin 1984;24:143-63. |
3. | Morax S. Oculo-motor disorders in craniofacial malformations. J Maxillofac Surg 1984;12:1-10. |
4. | Carruthers JD. Strabismus in craniofacial dysostosis. Graefes Arch Clin Exp Ophthalmol 1988;226:230-4. |
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. |
6. | Singh A, Sharma A, Sharma P. Congenital bilateral aplasia of medial recti in a family. JAMA Ophthalmol 2013;131:798-800. |
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