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Case of the week 184 (
May 2015 )
XT of the blind eye
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35 years old patient complaining of outward
deviation of the Lt eye. He has had a long past
history of Lt ocular trauma, sublaxation of the
crystalline lens, organized vit.hge and
inoperable old RD.
He asks for cosmetic surgery for the XT of his
Lt blind eye. |
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Because of the poor vision in the left eye,
cosmetic surgery for the exotropia should be
limited to this eye as long as the angle of
deviation could be aligned by working on 2
horizontal recti. In cases like this, where
the XT is huge and at least 3 ms are needed
to correct it. It is usually a hard job to convince
such patients that this huge XT will not be corrected
without working on their seeing eye. Adding one muscle from
the Rt sound eye to the surgical plan
usually gives satisfactory
results
A
lateral rectus recession of the sound Rt eye
was needed for perfect surgical correction
1. Before taking
the decision of working on the sound eye in a huge XT it
is the surgeon's responsibility to be sure that it is a comitant strabismus
2. Correction of this huge XT
could be achieved by working only on the exotropic eye but this usually results in disfiguring incomitance
in extreme gazes due to overwork on the MR
or the LR
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