Download 2011-2012 Basic and Clinical Science Course, Section 6: by Edward L. Raab, MD, JD PDF

By Edward L. Raab, MD, JD

Examines the scientific positive aspects, analysis and remedy of esodeviations and exodeviations, horizontal and vertical deviations, amblyopia and precise varieties of strabismus. Discusses the entire diversity of pediatric ocular problems, extraocular muscle anatomy, motor and sensory body structure and the way to set up rapport with young ones in the course of an ocular exam. comprises a number of photographs, together with colour images. lately revised 2010 2011.

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Extra resources for 2011-2012 Basic and Clinical Science Course, Section 6: Pediatric Ophthalomology and Strabismus (Basic & Clinical Science Course)

Example text

It consists of the extraocular muscles, the extraocular muscle sheaths, and the intermuscu lar membrane. Whether the muscle cone extends to the orbital apex is controversial. Muscle Capsule Each rectus muscle has a surrounding fascial capsule that extends wit h the muscle from its origin to its insertion. These capsules are thin posteriorly, but near th e equator th ey thicken as they pass through the sleeve of the Tenon capsule, continuing anteriorly with 20 • Pediatric Ophthalmology and Strabismus septum of Zinn Lateral ,"0'".

3. Is the diplopia worse on looki ng to the left or to the right? Patient's answer: Looking to the left [the field of action of the left lateral rectus]. Table 3· ' Action of the Extraocular Muscles from Primary Position Muscle* Primary Secondary Tertiary Medial rectus Lateral rectus Inferior rectus Superior rectus Inferior oblique Superior oblique Adduction Abduction Depression Elevation Extorsion Intorsion Extorsion Intorsion Elevation Depression Adduction Adduction Abduction Abduction * The superior muscles are intortors; the inferior muscles, extortors.

31 In primary position , the superio r and inferior rectus muscle planes form an angle of 23° with the visual axis (y-axis) and inse rt slightly anterior to the z-axis (Figs 3-4, 3-5). Therefore, from primary position , the co ntractio n of the supe rior rectus has 3 effects: primary elevation around the x-axis, secondary intorsion arollnd the y-axis. and adduction around th e z-axis. The relative strengt h of the superior rectus muscle can be 111 0St readily observed by aligning th e visual axis parallel to the muscle plane axis- that is, when the eye is rotated 23° in abduct io n.

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