| Post operative |
 |
All of these patients
with alternating esotropia have nearly equal
vision in both eyes, that is because each eye is
taking fixation half of the time. Stereo acuity
is almost lost.
Preoperative diplopia testing is extremely
important in the determination of what surgical
management should be done. It helps in deciding
if the patient should have surgery, what surgery
should be done, and when to do it. The
evaluation of postoperative diplopia also helps
in determining the course of action—e.g.,
whether to wait and reassure, manage medically
with prisms, or reoperate.
Intractable
diplopia after strabismus surgery in adults
without previous diplopia is very rare. The
diagnostic use of prisms prior to surgery may
identify some patients who have little or no
risk of postoperative diplopia, as well as a
group of patients with a small but definite risk
of intractable postoperative diplopia.
The prism adaptation test
is a pre-operative diagnostic test to identify
the potential for fusion and predict the risk of
diplopia in patients without the potential for
binocular single vision, before embarking on
cosmetic surgery.
In a patient like
this with huge ET ( 90 PD ), the surgical plan
is BMR recession 7.5 mm combined with one LR
resection 10 mm, this works good with me. |
.jpg)
