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2004 Series -  June 15, 2004 Lecture 29 of 50  NEXT»

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This 3-year-old boy had surgery at age 2 years for an ependimoma.  Immediately afterward he developed a large left esotropia.  Botulinum toxin was injected in the left medial rectus six months after the neurosurgery.  The alignment was not improved.  The child will not tolerate patching of the right eye.

1.  The most likely diagnosis is:
 

a.  left III nerve palsy
b.  left VII nerve palsy
c.  left VI nerve palsy
d.  none of the above

2.  Patching of the right eye is done for the following:
 

a.  prevent amblyopia in the left eye
b.  limit contraction of the left medial rectus
c.  avoid diplopia
d.  all of the above

3.  Treatment of the deviation can be accomplished best by: 
  a.  recession of the left medial rectus and resection of the left lateral rectus
b.  more Botox in the left medial rectus
c.  recession of the left medial rectus and muscle transfer shifting the left
     superior and inferior rectus toward the left lateral rectus
d.  sufficient surgery on the horizontal recti of the right eye


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Lecture 29 of 50 «Previous Lecture   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50    Next»
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