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Sixth nerve palsy, or abducens nerve palsy, is a disorder associated with dysfunction of cranial nerve VI (the abducens nerve), which is responsible for causing contraction of the lateral rectus muscle to abduct (i.e., turn out) the eye. [1]
The earliest successful strabismus surgery intervention is known to have been performed on 26 October 1839 by Johann Friedrich Dieffenbach on a 7-year-old esotropic child; a few earlier attempts had been performed in 1818 by William Gibson of Baltimore, a general surgeon and professor at the University of Maryland. [2]
The effort to correct eye misalignment causes eye strain, leading to a range of symptoms that complicate diagnosis and treatment. Symptoms can mimic those of chronic fatigue or motion sickness, making VH difficult to recognize and diagnose due to its broad symptom spectrum and lack of widespread recognition.
[53] [54] Most commonly used in adults, the technique is also used for treating children, in particular children affected by infantile esotropia. [55] [56] [57] The toxin is injected in the stronger muscle, causing temporary and partial paralysis. The treatment may need to be repeated three to four months later once the paralysis wears off.
During an eye examination, the presence of suppression and the size and location of the suppression scotoma may be the Worth 4 dot test (a subjective test that is considered to be the most precise suppression test), or with other subjective tests such as the Bagolini striated lens test, or with objective tests such as the 4 prism base out test.
Dissociated vertical deviation (DVD) is an eye condition which occurs in association with a squint, typically infantile esotropia. The exact cause is unknown, although it is logical to assume it is from faulty innervation of eye muscles.
Exophoria is a form of heterophoria in which there is a tendency of the eyes to deviate outward. [1] During examination, when the eyes are dissociated, the visual axes will appear to diverge away from one another.
From left to right: an accommodative fixation stick, a vertical prism bar, and a horizontal prism bar. The PFR involves placing a prism bar in front of an eye. In a patient with BSV, a natural shift of the eye occurs. When measuring horizontal fusion ranges, base in prisms assess fusional divergence while base out prisms assess fusional ...