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Ophthalmology
An Overview of Strabismology
Built from Strabismus Simplified, Second Edition
What’s inside
12 sections · 82 slides
Overview
- Scope of this presentation
Binocular Single Vision
- Binocular single vision
- Neural investment in the visual system
- Requirements for maintaining binocular single vision
- Formation of the three-dimensional percept
Extraocular Muscles
- The six extraocular muscles
- Front view of the extraocular muscles in the orbit
- Extraocular muscles viewed from above
- Muscle groups and their functional pairs
Planes and Axes of Eye Movement
- Listing's planes and Fick's axes
- The three planes and their axes of rotation
- Planes and axes of ocular rotation
Ductions and Versions
- Definition of ductions and versions
- Horizontal and vertical ductions
- Torsional ductions
- Duction movements of the right eye
- Limitation of ductions in paresis
- Conjugate and disjugate binocular movements
- Versions in the diagnostic planes
- Additional version positions and cycloversions
- Version movements in the nine gaze positions
Vergences
- Horizontal vergences
- Horizontal vergence movements
- Vertical and torsional vergences
- Vertical divergence
- Cyclovergence
- Clinical importance of fusional vergences
Yoked Muscles and the Innervational Laws
- Agonists, synergists and antagonists
- Yoke relationships change with the movement
- Hering's law of equal innervation
- Sherrington's law of reciprocal inhibition
- The innervational sequence in a binocular movement
Retinal Correspondence
- Primary and common visual directions
- Normal retinal correspondence
- Bifoveal correspondence with normal alignment
- The horopter and Panum's fusional area
- Disparate points and binocular diplopia
Strabismus: Definitions and Classification
- Orthophoria and the definition of strabismus
- Heterotropia, heterophoria and intermittent squint
- Concomitant and incomitant strabismus
- Classification of strabismus
- Horizontal concomitant strabismus
- Vertical concomitant strabismus
- Torsional strabismus
- Subtypes of incomitant strabismus
- Cranial nerve palsies and the paresis-paralysis distinction
Consequences and Adaptations
- Confusion
- Diplopia in strabismus
- Confusion and diplopia in convergent strabismus
- Motor adaptations to strabismus
- Sensory adaptations: suppression
- Anomalous retinal correspondence
- The sensory response to a strabismus
- The critical period of neural plasticity
- Facultative and obligatory suppression
- Amblyopia as the outcome of obligatory suppression
- Cascade of consequences following a strabismus
The Role of a Strabismologist
- Why the paediatric age group matters most
- Assessment of vision and correction of refractive error
- Assessment of the accommodation and convergence relationship
- Management of suppression and amblyopia
- Orthoptic treatment for low fusional reserves
- Correction of significant ocular deviation
- Systemic and neurological screening in squint
- The six duties of the strabismologist
- The composite role of the strabismologist
Summary
- Key points: normal binocular function
- Key points: strabismus and its management
- Suggested reading
- Suggested reading (continued)
- Strabismus Simplified