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Duane Retraction Syndrome Tanya Glaser, MD Laura B. Enyedi, MD PREOPERATIVE CONSIDERATIONS Duane retraction syndrome (DRS) is a spectrum of eye motility disorders caused by misinnervation of the lateral rectus…

Paralytic Strabismus Jared E. Duncan, MD PREOPERATIVE CONSIDERATIONS Paralytic strabismus refers to a group of eye muscle impairments that results from innervation interruption to the third, fourth, and/or sixth cranial…

Pattern Strabismus Michelle S. Go, MD Laura B. Enyedi, MD PREOPERATIVE CONSIDERATIONS Clinical evaluation should include measurement of deviation in multiple positions of gaze with particular attention to the difference…

Posterior Fixation Sutures Charles J. Bock Jr, MD PREOPERATIVE CONSIDERATIONS In strabismus where a strengthening procedure is contraindicated or not possible, weakening of the contralateral yoke muscle may be considered….

Adjustable Sutures in Strabismus Surgery Federico G. Velez, MD PREOPERATIVE CONSIDERATIONS Indications: Patient selection: Any patient undergoing eye muscle surgery who can tolerate adjustment under topical anesthesia (pediatric patients if…

Superior Oblique Procedures HongVan Le, MD SUPERIOR OBLIQUE MUSCLE The superior oblique (SO) intorts, depresses, and abducts the eye (see Chapter 42). Patients with a SO palsy will typically demonstrate…

Inferior Oblique Procedures Yasmin Poustchi Mali, MD WEAKENING OF THE INFERIOR OBLIQUE: MYECTOMY, RECESSION, ANTERIORIZATION, AND EXTIRPATION Preoperative Considerations Unilateral superior oblique palsy: Perform preoperative strabismus measurements and intraoperative forced…

Strengthening Rectus Muscles Jagger C. Koerner, MD, MBA INTRODUCTION There are four procedures to strengthen a rectus muscle: resection, plication (“muscle tuck”), advancement, and injection of bupivacaine (see Chapter 55)….

Weakening Rectus Muscles Megan X. Law, MD PREOPERATIVE CONSIDERATIONS Recessions move the muscle insertion to a new location closer to its origin to weaken the effect of the muscle. There…