What's new for us in strabismus?

Abstract

Strabismus is one of the most challenging subspecialties encountered in the field of ophthalmology. The concept of etiology of strabismus is being advanced with the development of newer imaging modalities and increased understanding of the genetics of strabismus. Imaging is also being used to aid in the planning of strabismus surgery. Newer horizons are being explored in the amblyopia management. The good old eye-pad is being replaced with the iPad. Early detection of loss of stereopsis is being used to decide the timing for strabismus surgery. Improvement of binocular summation has been discovered as a benefit of corrective strabismus surgery. Newer surgical techniques such as new transposition procedures are being developed to correct complex strabismus. Strabismus surgeries aided by adjustable sutures have increased the precision of a strabismologist. A new light has been thrown on the psychosocial impact of strabismus. A present-day strabismologist has advanced from the goal of ocular alignment to a bigger perspective "to regain the paradise lost: stereopsis."

Figure 1

High-resolution magnetic resonance imaging images showing (a) absence of left seventh nerve (b) bilateral sixth nerve hypoplasia in Mobius syndrome

Figure 2

A new condition “synergistic innervational downshoot” diagnosed with the help of dynamic magnetic resonance imaging (a) magnetic resonance imaging orbit showing contraction of both right eye and left eye lateral rectus (increase in cross-section of muscle) on dextrogaze and contraction of right eye inferior rectus and left eye lateral rectus on levogaze, (b) preoperative nine gaze clinical photograph, (c) postoperative nine gaze clinical photograph

Figure 3

Visual assessment using Teller Acuity Cards

Figure 4

Horizontal Lang's two pencil test “a simple yet sensitive tool for the assessment of stereopsis”

Figure 5

Frisby-Davis distance stereoacuity test “an established indicator for the timing of strabismus surgery in intermittent divergent squint”

Figure 6

Adjustable partial vertical recti transposition in a patient of left lateral rectus palsy (a) preoperative clinical photograph, (b) postoperative clinical photograph, (c) schematic diagram showing the surgical technique

Figure 7

Modified Nishida technique in management of absence of medial rectus (a) preoperative clinical photograph, (b) postoperative clinical photograph, (c) schematic diagram showing the surgical technique