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Case of the week 104 (
March 2013 )
V pattern esotropia
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The mother of this 6 years old girl
complained of the inward deviations of the eyes
of her child. The condition started since birth
as told by the mother with no changes with time.
Examination reveals normal fundus, bilateral
emmetropic eyes |
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This is a typical case of antimongoloid fissure esotropic
infant , those
infants usually present with :
V pattern
Infantile esotropia
The antimongoloid fissure which could be associated with pulley
heterotopy. In this case the medial pulleys would be
displaced upward and the lateral pulleys displaced
downward. According to the pulley theory, the ‘V’
pattern is caused by the vertical displacement of the
horizontal rectus muscle action. Of Course pulley
displacement must be confirmed by coronal imaging of the
mid-orbit, but this is not readily available because of
cost . The traditional treatment for a case like this is
bimedial rectus recession with down shift of the recessed medial recti.
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