paralytic squint

14
PARALYTIC SQUINT KANISHK DEEP SHARMA ROLL NO. 50

Upload: dr-kanishk-sharma

Post on 15-Apr-2017

535 views

Category:

Health & Medicine


1 download

TRANSCRIPT

Page 1: Paralytic squint

PARALYTIC SQUINT

KANISHK DEEP SHARMAROLL NO. 50

Page 2: Paralytic squint

• Uncoordinated eye movement• Angle of squint varies• Motor imbalance

Page 3: Paralytic squint

ETIOLOGY

1. Lesion of nerve2. Lesion of muscles

Page 4: Paralytic squint

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

Page 5: Paralytic squint

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

Page 6: Paralytic squint

4. Defective ocular motility5. Complementary head postures– Attempt to lessen diplopia– Head tilt to avoid torsion

Page 7: Paralytic squint

SEQUALAE

• Weakness of paretic muscle• Overacting contralateral synergistic muscle• Inhibitory palsy of contralateral antagonist

Page 8: Paralytic squint

TESTS

1. Record of visual acuity2. Ocular motility– Perimetry

3. Inspection of compensatory head postures

Page 9: Paralytic squint

4. Diplopia charting– Dark room procedure– Armstrong's glasses– 4ft distance, fine linear light– Primary & other positions of gaze measured

Page 10: Paralytic squint

5. Hess charting– Explains muscle paralysis & pathological sequlae

Page 11: Paralytic squint

6. Field of binocular fixation7. Forced duction test

Page 12: Paralytic squint

MANAGEMENT

1. Treatment of cause2. Conservative measures– Vit B complex, systemic steroids

3. Diplopia treatment– Occluder on affected eye

Page 13: Paralytic squint

SURGERIES

1. Muscle weakening procedure– Recession, marginal myotomy, myectomy

2. Muscle strengthening procedures– Resection, tucking advancement

3. Changing direction of muscle action

Page 14: Paralytic squint

THANK YOU