Divergent Strabismus Fixus

ABSTRACT

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.