ABSTRACT
Five cases of the dog-bite syndrome--palsy of the superior oblique muscle and a paradoxic inability to elevate the eye in adduction--are described. It is suggested that no treatment be given in the acute phase unless there are symptoms in the primary position, in which case peritrochlear injection of a depot steroid within 2 weeks of the injury may be of benefit. If after several months the ocular motility is still significantly restricted an attempt can be made to remove local scar tissue, with insertion of anchor sutures; recession of the inferior rectus of the fellow eye with adjustable sutures should correct residual symptomatic hypertropia.
Subject(s)
Diplopia/therapy , Eye Injuries/therapy , Ophthalmoplegia/therapy , Adolescent , Adult , Animals , Bites and Stings/complications , Child , Diplopia/etiology , Dogs , Ethmoid Sinus , Eye Injuries/complications , Eye Injuries/etiology , Eye Movements , Female , Humans , Male , Middle Aged , Sinusitis/complications , SyndromeABSTRACT
The results of conventional strabismus surgery are always somewhat uncertain, despite the most careful preoperative assessment. Yet it is important to achieve good alignment in patients with fusion potential who have intermittent exotropia, extraocular muscle paresis or a restrictive syndrome. Planning surgery for patients with thyroid myopathy and planning reoperations is particularly difficult. In 30 patients with various strabismus disorders the use of adjustable sutures proved safe and of value; the results were unacceptable in only 5 of the 28 patients with horizontal deviations. The inconvenience for the surgeon and the extra discomfort for the patient seemed outweighed by the predictability of the surgical result.
