EVALUATION OF CORRECTION OF VERTICAL DEVIATION ASSOCIATED WITH INFANTILE ESOTROPIA

Abstract

nfantile esotropia is by far the most common type of strabismus seen in infants & children. The cause is still unknown. It is usually obvious about age of 6 months. It is characterized by a large stable angle of deviation, a

limited potential for single binocular vision, an associated vertical deviations in the form of inferior oblique overaction (IOOA), and / or dissociated vertical deviation (DVD). Inferior oblique overaction may represent a cosmetic blemish and by far the most common association with infantile esotropia (63.2 % of all vertical deviation). Overaction of inferior oblique is manifested by overaction of the adducted eye as well as, the V- pattern strabismus. • The dissociated vertical deviation is also common type of vertical deviation associated with infantile esotropia, which usually becomes apparent

by the age of three years with variable incidence. In the present study, the incidence of DVD was 26.3 % all of cases. The cause of DVD is still unknown. The DVD manifisted by elevation, abduction and excyclotorsion. Both

eyes are usually affected but involvement is often asymmetrical. DVD may present as a phoria, intermittent tropia or a constant tropia. The most useful clinical feature of DVD is absence of corresponding hypotropia in contralateral eye on an alternate cover, when affected eye fixates while all "true" vertical deviations follow Bering's law and demonstrate a corresponding hypotropia of contralateral eye when the affected eye fixates. In this study all cases were examined both pre-and post-operatively to evaluate anatomical and functional results of management of vertical deviation. Inferior oblique overaction is treated surgically by graded recession anteriorization of Inferior oblique, which is a selective weakening procedure