Hello Dr. Lee. Fantastic explanation. My 3 year old daughter bumped her head on the floor 2 weeks ago and now has 6th nerve palsy to her left eye with esotropia. CT and MRIs were normal. We are hoping it resolves on its own. If it doesn’t do you perform surgery? Thanks.
Do you recommend patching to make the weaker eye stronger? What can be done to heal or improve the condition of the eye with the strabismus? Could eso or exotropia's also be caused by parasitic larvae cysts and if so how can you remove them? Your videos are amazing. Thank you so much.
Hello, I'm an orthoptist and often see patients with this condition. 1) Make sure there is no visual loss of the paretic eye. 2) If the patient has good vision, he still might not take up fixation, because the abduction deficit is too big. Then the patient can only take on fixation in adduction (head rotation to the side with the palsy). If so and you want to measure the angle of squint in primary position, you have two options: corneal light reflex or even better prism cover test. You hold the prism before the eye with the palsy. At first you might still not see a movement of the eye, if the prism is still too low. Then you increase the prism until you see a contrary movement (from outwards to inwards), because the medial rectus is still functioning. That means the prism has overcorrected the angle of squint and the last prism before that was the right one. Also you can use subjectiv methods. I hope that this could help you. Greetings from Germany
You're the best sir. I've been asking this question. This is the perfect simplest answer.
Excellent & clear explanation, as usual. Thanks!
Thank you very much. My professor thought I was crazy for asking that simple question.
Thank you Dr. Lee!
Hello Dr. Lee. Fantastic explanation. My 3 year old daughter bumped her head on the floor 2 weeks ago and now has 6th nerve palsy to her left eye with esotropia. CT and MRIs were normal. We are hoping it resolves on its own. If it doesn’t do you perform surgery? Thanks.
Do you recommend patching to make the weaker eye stronger? What can be done to heal or improve the condition of the eye with the strabismus? Could eso or exotropia's also be caused by parasitic larvae cysts and if so how can you remove them? Your videos are amazing. Thank you so much.
Great explanation! But I had a patient with an esotropic eye that doesn’t take up fixation during cover test - what would cause this?
Hello, I'm an orthoptist and often see patients with this condition. 1) Make sure there is no visual loss of the paretic eye. 2) If the patient has good vision, he still might not take up fixation, because the abduction deficit is too big. Then the patient can only take on fixation in adduction (head rotation to the side with the palsy). If so and you want to measure the angle of squint in primary position, you have two options: corneal light reflex or even better prism cover test. You hold the prism before the eye with the palsy. At first you might still not see a movement of the eye, if the prism is still too low. Then you increase the prism until you see a contrary movement (from outwards to inwards), because the medial rectus is still functioning. That means the prism has overcorrected the angle of squint and the last prism before that was the right one. Also you can use subjectiv methods. I hope that this could help you. Greetings from Germany
Me from birth 1963 crooked smile