By Edward L. Raab, MD, JD
Examines the medical good points, analysis and therapy of esodeviations and exodeviations, horizontal and vertical deviations, amblyopia and designated varieties of strabismus. Discusses the whole variety of pediatric ocular problems, extraocular muscle anatomy, motor and sensory body structure and the way to set up rapport with youngsters in the course of an ocular exam. includes a variety of photos, together with colour photographs. lately revised 2010 2011.
Read or Download 2011-2012 Basic and Clinical Science Course, Section 6: Pediatric Ophthalomology and Strabismus (Basic & Clinical Science Course) PDF
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Extra info for 2011-2012 Basic and Clinical Science Course, Section 6: Pediatric Ophthalomology and Strabismus (Basic & Clinical Science Course)
Can also occur: I eye moves upward and th e other downward. ) Other important terms and concep ts related to vergences include the followi ng: Tonic convergence The constant inn ervati o nal tone to the ex traocular muscles when a person is awake and alert. Because of th e anatomical shape of the bony orbit s and th e posi· tion of the rectus muscle origin s. the alignment of the eyes under complete muscle paralysis is divergent. Therefore. convergence tone is necessary in th e awake state to mainta in straight eyes even in the absence of strabismus.
For example, an acute left sixth nerve palsy in an adult can be diagnosed by asking the patient with diplopia 3 questions: 1. Is the diplopia horizontal or vertical? Patients answer: Horizontal [eliminating all but the medial and lateral recti]. 2. Is the diplopia worse at distance or at near? Patients answer: Distance [implicating the lateral recti, which act more at distance viewing than in convergence]. 3. Is the diplopia worse on looki ng to the left or to the right? Patient's answer: Looking to the left [the field of action of the left lateral rectus].
It passes Jaterally, superi orly. and posteri orl y, going inferior to the inferior rectus muscle and insertin g under the lateral rectus muscle in the posterolateral portion of the globe. in the area of the macula. The inferior oblique muscle form s an angle of 5 10 with the visual axis of the eye in primar y position (see Chapter 3, Fig 3-7). In primary position , the muscle's primary action is exto rsion (excycloduction ), secondar y act ion is elevat ion, and te rtiary action is abductio n.