One of the most valuable
contributions in the second part of the twentieth
century to the field of strabismus was the emphasis
on what has come to be known as the
A and V patterns of
strabismus
A pattern esotropia
usually
Associated with : Mongoloid Fissure ,
Medial Pulley down & Lateral Pulley up
The strabismus surgeon should be aware of the
existence of pulleys.
Although the surgeon will neither observe nor
manipulate these structures they are an
important factor in a proper diagosis in many
cases
Surgery on the horizontal rectus
muscles alone may effectively reduce vertical
incomitance. Thus, when dysfunction of the oblique
muscles is not evident. ttt of A pattern Et is :
Horizontal Surgery + MR upshift & LR down
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