Ординатура / Офтальмология / Английские материалы / Illustrated Tutorials in Ophthalmology Kanski, Bolton 2001
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‘V’ pattern deviation
Signs |
Treatment |
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‘V’ pattern esotropia |
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Bilateral medial rectus recessions + |
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downward transposition |
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• Difference between upand |
‘V’ pattern exotropia |
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downgaze is 15 or more |
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• |
Bilateral lateral rectus recessions |
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+ upward transpositions |
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‘A’ pattern deviation
Signs |
Treatment |
• Difference between upand |
‘A’ pattern esotropia |
downgaze 10 or more |
• Bilateral medial rectus recessions |
|
+ upward transposition |
‘A’ pattern exotropia
•Bilateral lateral rectus recessions
+downward transposition
THYROID EYE DISEASE
1.Soft tissue involvement
•Periorbital and lid swelling
•Conjunctival hyperaemia
•Chemosis
•Superior limbic keratoconjunctivitis
2.Eyelid retraction
3.Proptosis
4.Optic neuropathy
5.Restrictive myopathy
Soft tissue involvement
Periorbital and lid swelling |
Conjunctival hyperaemia |
Chemosis |
Superior limbic |
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keratoconjunctivitis |
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Signs of eyelid retraction
Occurs in about 50%
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Bilateral lid retraction |
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Bilateral lid retraction |
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No associated proptosis |
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Bilateral proptosis |
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Unilateral lid retraction |
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Lid lag in downgaze |
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Unilateral proptosis |
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Proptosis
•Occurs in about 50%
•Uninfluenced by treatment of hyperthyroidism
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Axial and permanent in about 70% |
May be associated with choroidal folds |
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Treatment options
•Systemic steroids
•Radiotherapy
•Surgical decompression
Restrictive myopathy
•Occurs in about 40%
•Due to fibrotic contracture
Elevation defect - most common |
Abduction defect - less common |
Depression defect - uncommon |
Adduction defect - rare |
ORBITAL INFECTIONS AND
INFLAMMATIONS
1.Orbital cellulitis
2.Idiopathic orbital inflammatory disease (IOID)
3.Dacryoadenitis
4.Orbital myositis
Orbital cellulitis
•Infection behind orbital septum
•Usually secondary to ethmoiditis
•Presentation - severe malaise, fever and orbital signs
Signs
•Severe eyelid oedema and redness
•Proptosis - most frequently lateral and down
•Painful ophthalmoplegia
•Optic nerve dysfunction if advanced
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