Oftalmoplegía externa congénita parcial y bilateral en un adolescente / Partial and bilateral congenital external ophthalmoplegia in an adolescent

Se presenta el caso clínico de un paciente de 18 años de edad, quien fue atendido en la consulta de estrabología del Hospital Oftalmológico Amistad Argelia-Cuba de la República de Argelia por presentar fotofobia, ptosis palpebral, mala visión y estrabismo divergente. Se le hizo un examen oftalmológico completo, prueba de prisma, luces de worth y se constató que tenía una oftalmoplejía congénita externa parcial y bilateral con ambliopía, sin manifestaciones neurológicas. Se le indicó tratamiento con vitaminas y no se realizó propuesta quirúrgica debido a la cantidad de músculos afectados y el gran riesgo de una diplopía residual

The case report of an 18 years patient is presented who was assisted in the estrabism service of Amistad Argelia-Cuba Ophthalmologic Hospital in the Republic of Algeria due to photophobia, ptosis palpebral, poor vision and divergent strabismus. A complete ophthalmologic exam was carried out, prism test, worth lights and it was verified that he had a partial and bilateral external congenital ophthalmoplegia with amblyopia, without neurological manifestations. Treatment with vitamins was indicated and there was no surgical proposal due to the quantity of affected muscles and the great risk of a residual diplopia

Divergent Strabismus Fixus

Strabismus fixus is a rare condition in which one or both eyes are anchored, as a rule, in a position of extreme adduction or abduction. The involved eye is "fixed" in this position and cannot be moved, and the forced duction test will confirm the immobility of the eye. The condition generally is thought to be congenital and caused by fibrosis, which would explain the loss of elasticity of the rectus muscle. Divergent forms of strabismus fixus not accompanied by ptosis or generalized fibrosis of the extraocular muscle are even more unusual. The authors experienced one case of divergent strabismus fixus in a 23 year old female patient. We performed complete disinsertion of both lateral rectus muscle and recession of conjunctiva and Tenon's capsule, combined with 11 mm resection of medial rectus muscle of left eye. The result of that surgery, however, was not satisfactory. So we performed 11 mm resection of medial rectus muscle of right eye and temporary fixation of the globes with traction sutures in a position of abbuction on both eyes at 3 days after the first surgery. After 4 weeks, patient was remained 60 delta exodeviation but primary position and ocular motility were improved.