|
Answers: 2004 series - June 15, 2004
|
Lecture 29 of 50 NEXT»
|
To see views enlarged, click on the individual pictures...
| 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:
c -- This child has a left VI nerve palsy.
|
| 2. |
Patching of the right eye is done for the following:
d -- A patch on the right eye will help prevent amblyopia which is very likely to occur in a child this young. This patching will also encourage use of the left eye which would tend toward at least an attempt at abduction which would diminish innervation to the left medial rectus and discourage muscle contraction. Patching of the right eye would also eliminate diplopia.
|
| 3. |
Treatment of the deviation can be accomplished best by:
c -- This child appears to have no left lateral rectus function; that means alignment of the left eye will require a muscle transfer procedure. The type of transfer depends on the surgeon's preference.
|
|
Print this Page
