Deviated eye
Introduction
Introduction When the eyeball is skewed, that is, when looking at something or standing still, the "black eye" portion of the eyeball is not in the normal position, causing a double or strabismus. There are many kinds of strabismus, the most common is the inward deflection of the eyeball, medically known as esotropia, commonly known as "to the eye", "cross-eyed". The eyeball is deflected outward, called exotropia, commonly known as "oblique white eye." Of course, strabismus does not only refer to the situation in which the relative positions of the two eyes are obviously deformed, but also includes the case where the inclination is small, the surface is not easy to be perceived, and the binocular vision is not normal, and the cases where there is no oblique position at all but the eyes are abnormal. . Therefore, the concept of strabismus should be understood as the abnormal position of both eyes and the abnormality of both eyes.
Cause
Cause
The cause of eyeball deflection:
Eyeball deviation with diplopia is a common sign and symptom of ophthalmology, and its causes are many, mainly:
1, congenital anomalies such as congenital extraocular muscle paralysis or loss.
2, eyelid or head trauma such as traumatic wall fracture caused by extraocular muscle incarceration, limiting its activity; intracranial hemorrhage, skull base fracture and nerves that innervate the extraocular muscle.
3. Tumors in the orbit and intracranial and nasopharynx These tumors can directly compress or infiltrate the nerves that support the extraocular muscles or the extraocular muscles themselves.
4, intraocular and intracranial inflammation such as orbital cellulitis, encephalitis.
5, vascular disease acute bleeding within the eyelid or intracranial, thrombosis oppression dominates the nerve of the extraocular muscle or the lesion of the extraocular muscle itself.
6, myogenic diseases such as myasthenia gravis, extraocular myositis, thyroid-related eye diseases.
7, metabolic diseases such as diabetes, can cause oculomotor or abductor nerve paralysis.
8. Poisoning such as diphtheria, tetanus antitoxin and acute poisoning caused by carbon monoxide.
9. Mental factors are seen when rickets or visual fatigue occurs due to long hours of fine work.
Examine
an examination
Related inspection
Eye and sacral area CT examination double vision examination method ophthalmic examination covering method
Eyeball deflection check:
Children with strabismus should first check their vision and do a detailed eye examination. Regardless of whether your vision is normal or not, you should always have astigmatism and wear glasses if necessary.
1. Checking the binocular function:
(1) The three-level situation in which the same vision machine is used in the country to check the binocular vision function.
(2) Quantitative measurement of the stereoscopic vision function, and the stereoscopic sharpness is measured by the stereoscopic quantitative picture of the same machine or the random point stereogram of the Young's.
2. Refractive examination:
Atropine paralyzed ciliary muscle optometry: to understand whether there is amblyopia and the relationship between strabismus and refraction.
3. Determination of eye position and oblique angle:
Determine which type of strabismus it is. The size of the oblique viewing angle must be checked for surgical design.
4. Eye movement check:
Determine the function of the extraocular muscles and see if the eye movements are in place.
5. Is there a compensatory head position:
Help diagnose which extraocular muscle paralysis.
6. Determine the examination of the paralysis muscles:
Check the movement function of the eyeball, the gaze angle of each eye, and the gaze angle of each eye in each direction, using the red lens test or
Checks such as the Hess screen method can help determine.
7. Pull test:
(1) Estimate postoperative diplopia and patient tolerance after pulling the eyeball to the ortho position before surgery.
(2) Passive pull test can be used to understand whether there is mechanical contraction of the extraocular muscles or muscle spasm.
(3) Active contraction test to understand the function of the muscle.
8. Obscure inspection:
Quantitative determination was made using a hidden inclinometer. Detection of collection points: Helps diagnose muscle fatigue.
9. Regulatory set/adjustment (AC/A) ratio determination:
Help determine the relationship between strabismus and adjustment and collection.
Diagnosis
Differential diagnosis
Symptoms of eyeball skewiness:
Most babies under one year of age seem to have esotropia. Because the bridge of the nose is wider, it is common for the oriental people to have the inner suede, so that the white eyes look very little. In appearance, the black eyeballs of the two eyes (the cornea) are like the "cross-eyed eyes" that are "fighting" across the bridge of the nose. In fact, the eye position is positive. This phenomenon of pseudo-esoteric gaze is more pronounced when the baby is looking at the left and right sides. We can check it with a flashlight. Normal eyes can see light reflections on the cornea. If the eye position is positive or pseudo strabismus, the light reflection point is in the center of the pupil; if it is true strabismus, the light reflection point is off the center of the pupil. Fortunately, this phenomenon will automatically disappear when the baby grows up (because the nose is taller). However, this makes parents or grandparents mistakenly believe that all esotropia situations will automatically disappear. Because of this erroneous concept, many parents delayed the time for their children to go to the ophthalmologist, and missed the golden age of treating strabismus. True esotropia does not automatically disappear with age.
Intraocular transtensor tendon and external transversal muscle paralysis can produce intraocular oblique, and internal oblique produces ipsilateral diplopia.
Children with strabismus should first check their vision and do a detailed eye examination. Regardless of whether your vision is normal or not, you should always have astigmatism and wear glasses if necessary.
