2011-2012 Basic and Clinical Science Course, Section 6: by Edward L. Raab, MD, JD

By Edward L. Raab, MD, JD

Examines the scientific gains, analysis and therapy of esodeviations and exodeviations, horizontal and vertical deviations, amblyopia and specific sorts of strabismus. Discusses the total diversity of pediatric ocular problems, extraocular muscle anatomy, motor and sensory body structure and the way to set up rapport with childrens in the course of an ocular exam. includes quite a few pictures, together with colour pictures. lately revised 2010 2011.

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Additional info for 2011-2012 Basic and Clinical Science Course, Section 6: Pediatric Ophthalomology and Strabismus (Basic & Clinical Science Course)

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Sup erioris muscle becomes an aponeurosis in the region of the superi or fornix. This muscle has both a cutaneous and a tarsal insertion. BeSe Section 7, Orbit, Eyelids, and Lacrimal System, discusses this muscle in detail. Figure 2-3 shows the extraocu lar muscles and th eir relationship to one another; Table 2- 1 summari zes their characte ristics. Insertion Relationships of the Rectus Muscles Starting at the medial rectus and proceedin g to in ferior rectus, lateral rectus, and superior rectus muscles, the rectus muscle tendons inse rt progressively fart her from th e limbus.

And exposure of the superior oblique muscle tendon. Hemostasis can be achieved with cautery or with an absorbable hemostatic sponge. The sclera is thinnest just posterior to the 4 rectus muscle insertions. This area is the site for most muscle surgery, especiall y for recession procedures. Therefore, scleral perforation is always a risk during eye muscle surgery. The surgeo n can minimize this risk by using spatulated needles with swedged sutures • working with a clean, dry, and blood-free surgi cal field • using 101lpe magnification or the operating microscope Chapter 12 discusses these procedures and complications in g reater detail.

Since pulleys are located only a short distance fro m the globe center, small shifts in pulley location confer large shifts in extraocular muscle pulling direction. Heterotopy (malpositioning) of the rectus pulleys is a cause of incomitant strabismus and can mimic oblique muscle dysfunction by misdirecting the forces of the rectus muscle. Bony abnormalities can alter the extraocular muscle pulling direction by malpositioning the pulleys. Extorsion of the pulley array is associated with a V pattern; intorsion of the puLley array, with an A pattern.

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