Department of Ophthalmology, Pediatric Eye Clinic, University of Wisconsin-Madison.
'V' esotropia and excyclotropia after surgery for bilateral fourth nerve palsy.
Archives of Ophthalmology. 110(10):1419-22, 1992 Oct.
Six patients had residual diplopia at near in the downgaze position after surgery
for bilateral fourth nerve palsy.
They all showed a large excyclotropia in the downgaze position that was associated
with a "V"-pattern esotropia and could not fuse in the reading position
because of the size of the excyclotropia. They were treated with bilateral recessions
of the inferior recti, which resulted in an expansion of the single binocular
field of vision in downgaze, with an elimination of diplopia in the reading position.
None experienced a deterioration in their alignment in the primary position.