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Case of the week 105 (
March 2013 )
Sensory Exotropia
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58 years old lady was presented in the out
clinic of our memorial institute with white
cataract and huge XT of the left eye. There is
no history of any general illness, the lens
opacity was diagnosed since 4 years with gradual
progressive deminution of vision, the XT
appeared 6 months ago starting as small angle
outward deviation and ending with this huge
XT.US of this eye reported totally opaque lens,
retina in place, normal vitreous and normal
optic nerve head. Biometery was done and the
calculated power of the IOL needed is + 22.
VA is 6/18 OD ( minimal posterior subcapsular
cataract ) , HM OS
My colleagues referred the patient to the
strabismus unit, oculat motility examination
revealed simple comitant Lt XT |
Sensory exotropia is a condition of unilateral
divergence as a sequlae to long-standing poor
vision in one eye, which was caused by
refractive errors, unilateral aphakia unilateral
cataract or other
organic reasons. The most important aspect of
the management is to reverse a treatable cause
of the exotropia. Sensory exotropia secondary to senile cataract was often
observed.
Although, most patients with sensory exotropia
subsequent to senile cataract will not
experience postoperative diplopia after caearact
surgery, others complains of annoying diplopia with
spontaneous recovery in 1-3
months postoperatively. The patients should be
informed of the possibility of diplopia and the
subsequent possible need for corrective
strabismus surgery before consenting to cataract
surgery.
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