The Effect of Inferior Oblique Weakening Procedures on the Correction of Ocular Torsion

PURPOSE: To examine changes in ocular torsion after the weakening procedure for the inferior oblique muscle in patients with overaction of inferior oblique muscle (IOOA). METHODS: Twenty-eight eyes that had undergone the graded IO anteriorization combined with recession were evaluated. Twelve eyes from 11 patients had IOOA due to superior oblique muscle palsy (SOP) and 16 eyes from 9 patients had primary IOOA. Fundus photograph was taken to examine changes in torsional deviation before and after surgery. RESULTS: The average torsional deviation decreased from +17.5 +/- 7.3 degrees before surgery to +6.4 +/- 5.8 degrees after surgery, with the amount of correction being 11.1 degrees. It was corrected by 12.6, from +19.1 +/- 7.7 degrees to +6.5 +/- 4.8 degrees, in patients with SOP, and by 10 degrees, from +16.3 +/- 6.9 degrees to +6.3 +/- 6.6 degrees, in patients with IOOA (p<0.05). CONCLUSIONS: About 11o excyclotorsional correction was observed in patients with IOOA after IO anteriorization combined with recession.

A Case of Weaver Syndrome with Alternating Exotropia

PURPOSE: We report a first case of Weaver syndrome in Korea, accompanied by alternating exotropia and visual disturbance. METHODS: An 11-month-old girl showed the characteristic symptoms of Weaver syndrome along with alternating exotropia and visual disturbance. RESULTS: Ophthalmologic findings included alternating exotropia, hypertelorism, down-slanting palpebral fissure, and telecanthus. The angle of exotropia according to the Krimsky's test was 60 prism diopters. No limitation of extraocular movement was present. Visual acuity of both eyes showed poor following fixation. According to brain MRI, immature myelination of the anterior limb of the internal capsule, contracture and sclerotic changes of the optic canal and superior oblique fissure were present. Both optical nerves ran abnormally crooked. CONCLUSIONS: The author experienced a child with Weaver syndrome who showed alternating exotropia, visual disturbance, and characteristic findings according to brain MRI. Thus, we report one case of Weaver syndrome never been reported in Korea with the literature study.