ESOTROPIA Case discussion in detail for pg

Esotropia in detail

1. PRESENTER:- DR PRIYANKA MADRE MOMALE JUNIOR RESIDENT SETH GSMC & KEMH, MUMBAI ESOTROPIA

2. CASE REPORT : INFORMANT -MOTHER 8 YEAR OLD MALE CHILD CHIEF COMPLAINT 1) DEVIATION OF LEFT EYE WHICH WAS GRADUAL IN ONSET CONSTANT IN NATURE SINCE THE AGE OF 3 YEAR.

3. HISTORY OF TREATMENT TAKEN PATIENT HAD H/O CONSULTATION ELSEWHERE PRESCRIBED ON GLASSES COMPLIANT WITH GLASSES NO HISTORY OF EYE PATCHING PREVIOUS PRESCRIPTION OF GLASSES

4. CASE REPORT : NEGATIVE HISTORY NO SIGNIFICANT BIRTH HISTORY NO HISTORY OF CONSANGUINEOUS MARRIAGE IN PARENTS SEIZURE DISORDER FAMILIAL SQUINT EYE SURGERY/TRAUMA EYE PATCHING NO HISTORY OF

5. SYSTEMIC EXAMINATION: CHILD WAS OF AVERAGE BUILT AND WELL NOURISHED WNL

6. NORMAL WNL SINGLE CIRCULAR RTL CLEAR 12MMHG RIGHT EYE LEFT EYE LID AND ADNEXA CORNEA ANTERIOR CHAMBER IRIS PATTERN PUPIL LENS IOP OCULAR EXAMINATION: ANTERIOR SEGMENT NORMAL CLEAR 14MMHG CLEAR SINGLE CIRCULAR RTL NORMAL WNL CLEAR NORMAL

7. OCULAR EXAMINATION: VISUAL ACUITY

8. OCULAR EXAMINATION: POSTERIOR SEGMENT OD OS OU -WNL U

9. SQUINT EXAMINATION : HEAD POSTURE: NORMAL FACE TURN CHIN LIFT HEAD TILT NO FACIAL ASYMMETRY HIRSCHBERG TEST LE -30 DEGREE ESODEVIATION ABSENT

10. SQUINT EXAMINATION :SENSORY EXAMINATION WORTH’S FOUR DOT TEST : S/O LE SUPPRESSION STEREOPSIS (TITMUS FLY TEST) : 400sec OF ARC

11. SQUINT EXAMINATION :MOTOR EXAMINATION COVER-UNCOVER TEST: 1.COVER TEST : REVEALED LE ESOTROPIA 2.UNCOVER TEST : RIGHT EYE TOOK UP THE FIXATION ALTERNATE COVER TEST: RIGHT EYE: CENTRAL, STEADY & MAINTAINED LEFT EYE: CENTRAL, STEADY & UNMAINTAINED SUGGESTIVE OF CONSTANT LEFT EYE ESOTROPIA WITH RIGHT EYE DOMINANCE

12. MOTOR EXAMINATION: PBCT WITH GLASSES 55 BASE OUT 55-60 55-60 55-60 BASE OUT BASE OUT BASE OUT 60 BASE OUT NO A-V PATTERN DISTANT = NEAR

13. MOTOR EXAMINATION: EXTRAOCULAR MUSCLE MOVEMENTS ON DUCTION & VERSIONS ALL MOVEMENTS WERE FULL FREE PAINLESS & EQUAL IN ALL GAZES WITHOUT OVERACTION AND LIMITATION O O O O O O O O O O O O O O LE RE BE

14. DIFFERENTIAL DIAGNOSIS : ACCOMODATIVE ESOTROPIA

15. DIFFERENTIAL DIAGNOSIS : SENSORY ESOTROPIA

16. RIGHT EYE REFRACTIVE ERROR LEFT EYE NON-ACCOMODATIVE CONSTANT 55-60 ESOTROPIA EQUAL FOR BOTH NEAR & DISTANCE WITH NO A-V PATTERN WITH RIGHT EYE DOMINANCE WITH LEFT EYE AMBLYOPIA IN A NIL SYSTEMIC PATIENT PROBABLE DIAGNOSIS :

17. TREATMENT :

18. TREATMENT : SQUINT CORRECTION PLAN

19. MOTOR EXAMINATION:

20. ON DUCTION & VERSIONS ALL MOVEMENTS WERE FULL FREE PAINLESS & EQUAL IN ALL GAZES WITHOUT ANY OVERACTION AND LIMITATION

21. POST OPERATIVE MANAGEMENT

22. THANK YOU