Primary inferior oblique overaction-management by inferior oblique recession.

PURPOSE: To evaluate the effect of 10 mm inferior oblique recession in horizontal strabismus with V pattern and primary inferior oblique overaction. METHODS: Ten patients of V esotropia and exotropia with primary inferior oblique overaction underwent 10 mm inferior oblique recession by the methods described by Park and Stallard. Pre- and postoperative V pattern, inferior oblique overaction and binocularity were assessed. Patients were followed up for 3 months. RESULTS: The mean preoperative V pattern was 38.3 PD and the mean inferior oblique overaction was 22 PD. After surgery the mean correction of the V pattern was 26.9 PD and the mean residual V pattern was 11.4 PD. None of the patients had inferior oblique overaction postoperatively. 70% of the patients showed improvement in binocularity. CONCLUSION: 10 mm Inferior oblique recession by the described technique is a simple, safe and effective method for the cosmetic and functional treatment of horizontal deviation and V pattern with primary inferior oblique overaction

Comprehensive review of amblyopia: Types and management

The optimal method of treatment for a child depends on the patient's age at the time of diagnosis, the onset and type of amblyopia, and the degree of compliance attainable. In deprivation amblyopia, the cause of visual impairment (e.g., cataract, ptosis) needs to be treated first, and then the disorder can be treated such as other types of amblyopia. Anisometropic amblyopia needs glasses first. In strabismic amblyopia, conventionally amblyopia should be treated first, and then strabismus corrected. Correction of strabismus will have little if any effect on the amblyopia, although the timing of surgery is controversial. Best outcomes are achieved if amblyopia is treated before the age of 7 years. The earlier the treatment, the more efficacious it is. In selected cases of bilateral amblyopia, the more defective eye must be given a competitive advantage over the comparatively good eye. Glasses alone can work when a refractive component is present, but occlusion might make the glasses work faster. The gold standard therapy for amblyopia remains occlusion of the better eye although penalization is also evidenced to achieve equal results. Pharmacotherapy has been shown to achieve suboptimal outcomes. Newer monocular and binocular therapies based on neural tasks and games are adjuncts to patching and can also be used in adults