RT Journal Article
SR Electronic
T1 Resolution of hypertropia with correction of intermittent exotropia
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 1322
OP 1324
DO 10.1136/bjophthalmol-2013-303553
VO 97
IS 10
A1 Michael C Struck
A1 Timothy J Daley
YR 2013
UL http://bjo.bmj.com/content/97/10/1322.abstract
AB Purpose We describe the spontaneous resolution of hypertropia in a subset of patients with preoperative exotropia and hypertropia, who underwent surgery for intermittent exotropia alone. Design This was a retrospective case series. Methods The charts were reviewed of 17 patients who underwent surgical correction for an intermittent exotropia, who additionally were noted on preoperative exam to have greater than 5 prism dioptres of vertical deviation in primary position. Patients were excluded if they had prior strabismus surgery, dissociated vertical deviation, and paretic or restrictive deviations. Results All patients were documented to have complete resolution of any vertical deviation in any field of gaze. This effect was noted to persist. Conclusions We propose that the measured distance hypertropia, which is coincident with intermittent exotropia, even with the appearance of superior oblique dysfunction or inferior oblique overaction, is not created by a true vertical or cyclovertical muscle imbalance. Further, that the reduction of the hypertropia at near fixation predicts its resolution with horizontal muscle surgery. Therefore, vertical surgery should not be performed to address the coincident vertical deviation in these patients.