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Ophthalmology
Vertical Strabismus
Built from Strabismus Simplified, Second Edition
What’s inside
5 sections · 62 slides
Overview
- Scope of this topic
Definitions and anatomy
- Definition of vertical strabismus
- Naming convention for a vertical deviation
- The four vertical muscles of each eye
- Cyclovertical muscles as a single group
- Vertical fusional vergence and symptoms
- Pseudovertical squint
- Causes of pseudovertical squint
- Comitant vertical strabismus with left hypertropia
- Classification of cyclovertical strabismus
- Incomitant vertical squint: neurogenic causes
- Incomitant vertical squint: myogenic and restrictive causes
Clinical assessment
- Presenting features of cyclovertical squint
- Points to note on history and examination
- Clinical significance of a head posture
- Interpretation of face turn
- Interpretation of head tilt and chin position
- Objective and subjective measurement of the deviation
- Testing limitation of ocular movement
- Parks three step test
- Parks three step test in right superior oblique palsy
- Inference table for the Parks three step test as printed
- Inference from the Parks three step test
- Fallacies of the head tilt test
- Diplopia charting in cyclovertical squint
- Diplopia charting in dissociated vertical deviation
- Double Maddox rod test for cyclotropia
- Other methods of measuring cyclodeviation
- Fundus assessment of torsion
- Forced duction test
- Interpretation of the forced duction test
- Exaggerated forced duction test for the obliques
Dissociated deviations
- Dissociated vertical deviation: definition
- Terminology and the DVD syndrome
- Variants of dissociated deviation
- Prevalence and associations of DVD
- Differentiating inferior oblique overaction from DVD
- Dissociated vertical deviation of the left eye with inferior oblique overaction
- Differences between inferior oblique overaction and DVD
- Diagnostic tests for DVD
- Bielschowsky's graded density filter bar test
- Depth of suppression demonstrated in dissociated vertical deviation
- Etiology of dissociated vertical deviation
- Surgical management of DVD
- Total anteropositioning of the inferior obliques
- Dissociated horizontal deviation
- Treatment of DHD and dissociated esotropia
Differential diagnosis
- Approach to the differential diagnosis
- Acquired monocular elevation deficit with right hypotropia
- Supranuclear causes of incomitant vertical squint
- Types of congenital double elevator palsy
- Skew deviation with right hypotropia
- Intranuclear and nuclear causes of incomitant vertical squint
- Restrictive causes of incomitant vertical squint
- Key points to carry away
- Suggested reading
- Suggested reading (continued)
- Strabismus Simplified