The Case of the Missing Muscles.
Background: Congenital absence of the superior oblique (SO) is a rare cause of strabismus. It should be suspected in a patient with a presumed diagnosis of SO palsy presenting with amblyopia, an unusually large vertical deviation, and a significant horizontal deviation. Case Report: We report a case...
| Published in: | Optometry & Visual Performance Vol. 3; no. 1; pp. 56 - 61 |
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| Main Authors: | , , |
| Format: | case study pictorial Journal Article |
| Published: |
Optometric Extension Program
Feb2015
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=101382159&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 101382159 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 23253479 HOOW jtl: Optometry & Visual Performance issn: 23253479 maglogo: N pubinfo: dt: Feb2015 vid: 3 iid: 1 pid: 46881 pub: Optometric Extension Program place: Lutherville Timonium, Maryland artinfo: ui: 101382159 101382159 103807496 101382159 ppf: 56 ppct: 5 formats: tig: atl: The Case of the Missing Muscles. aug: au: Silbert Aumiller, Mira Gallaway, Michael Bailey, Jo Ann T. affil: Wilmington VA Medical Center, Wilmington, Delaware sug: subj: Oculomotor Muscles Abnormalities Amblyopia Diagnosis Amblyopia Therapy Torticollis Etiology Strabismus Etiology Abnormalities Physiopathology Infant Child Combined Modality Therapy Abnormalities Diagnosis Infant: 1-23 months Child: 6-12 years ab: Background: Congenital absence of the superior oblique (SO) is a rare cause of strabismus. It should be suspected in a patient with a presumed diagnosis of SO palsy presenting with amblyopia, an unusually large vertical deviation, and a significant horizontal deviation. Case Report: We report a case of an infant presenting at five months of age with a significant right head tilt since birth and significant vertical and horizontal strabismus. The patient was not meeting developmental milestones. The infant was referred for surgery, where it was discovered that she had a congenital lack of SO muscles. After surgery, the patient was treated with amblyopia therapy and vision therapy and followed for six years. Surgical and non-surgical intervention led to a good visual outcome, enhanced achievement of developmental milestones, and improved cosmesis. Conclusion: Although absence of SO muscles is a rare etiology for torticollis and strabismus, it should be considered in cases of early and significant ocular misalignment. The presence of horizontal and vertical strabismus in a patient with a presumed congenital SO palsy should raise suspicion of an absent SO. Early intervention can make a significant difference for the patient in terms of both visual outcome and cosmesis. This patient is the youngest documented case of SO aplasia and the first published case using surgery and vision therapy in combination. pubtype: Academic Journal doctype: case study pictorial Journal Article ougenre: Unknown language: English refInfo: holdings: @attributes: islocal: N |
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