Paralytic squint
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Transcript of Paralytic squint
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PARALYTIC SQUINT
KANISHK DEEP SHARMAROLL NO. 50
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• Uncoordinated eye movement• Angle of squint varies• Motor imbalance
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ETIOLOGY
1. Lesion of nerve2. Lesion of muscles
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Lesions due to
1. Injury2. Inflammation-syphilis, disseminated sclerosis
3. Vascular diseases-hemorrhage, aneurysm,arteriosclerosis
4. Neoplasms-brain tumor
5. Toxins-alcohol, lead, carbon monoxide
6. Degeneration-chronic nuclear ophthalmoplegia
7. Myasthenia gravis
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SYMPTOMS
1. DIPLOPIA– In field of action of paralyzed muscle– Long duration- suppression of false image
2. Vertigo & nausea– Action required towards paralysed muscle
3. False projection– Binocular diplopia– Secondry deviation
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4. Defective ocular motility5. Complementary head postures– Attempt to lessen diplopia– Head tilt to avoid torsion
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SEQUALAE
• Weakness of paretic muscle• Overacting contralateral synergistic muscle• Inhibitory palsy of contralateral antagonist
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TESTS
1. Record of visual acuity2. Ocular motility– Perimetry
3. Inspection of compensatory head postures
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4. Diplopia charting– Dark room procedure– Armstrong's glasses– 4ft distance, fine linear light– Primary & other positions of gaze measured
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5. Hess charting– Explains muscle paralysis & pathological sequlae
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6. Field of binocular fixation7. Forced duction test
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MANAGEMENT
1. Treatment of cause2. Conservative measures– Vit B complex, systemic steroids
3. Diplopia treatment– Occluder on affected eye
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SURGERIES
1. Muscle weakening procedure– Recession, marginal myotomy, myectomy
2. Muscle strengthening procedures– Resection, tucking advancement
3. Changing direction of muscle action
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THANK YOU