Strabismus deorsoadductorius
| Classification according to ICD-10 | |
|---|---|
| H50.2 | Vertical strabismus - hypotropia |
| ICD-10 online (WHO version 2019) | |
As strabismus deorsoadductorius refers to a specific pathology within the squint medicine ( Strabismus ).
shape
This is understood to mean the congenital squint position of an eye in the form of an increasing lower position ( hypotropia ) with increased gaze turning towards the nose ( adduction ). The extent of the vertical squint deviation remains relatively constant when looking up and down, so it is concurrent . A so-called A-symptom is often associated with the strabismus deorsoadductorius , the increase in a horizontal internal squint angle when looking up, or its decrease when looking down.
etiology
The cause of a deorsoadductor strabismus is generally assumed to be a congenital disorder of the oblique muscles of the eye, i.e. an overfunction of the superior oblique muscle and an underactive inferior oblique muscle . There is apparently still disagreement in science about the exact origin of this form of squint. Different scenarios are discussed, ranging from early childhood paresis to the possibility of malnervation . Some also consider the depression to be the primary clinical picture and the horizontal deviation to be a secondary feature. In summary, however, there seems to be a disruption in the overall interplay of oblique and straight synergists and antagonists .
therapy
Since a strabismus deorsoadductorius is almost always associated with a horizontal internal squint, this inward squint is usually reduced first during an operative intervention ( squint operation ). This generally results in an improvement in the lower position even in the primary position , which especially occurs in adduction. However, the disorder of the Mm. obliqui also have an effect on the horizontal squint angle when looking up and down, which is why this aspect can make an operation appropriate to the findings necessary. Depending on the extent of the horizontal deviation when looking above or below, a corresponding distribution of the dosage between the two mm. obliqui, if necessary an intervention is carried out on only one of the two muscles.
Differential diagnosis
As a concomitant strabismus deorsoadductorius strabismus is to be differentiated from a possibly isolated paresis of the musculus obliquus inferior, which usually shows incomittent strabismus deviations.
See also
literature
- Herbert Kaufmann (Ed.): Strabismus. With the collaboration of Wilfried de Decker et al. Enke, Stuttgart 1986, ISBN 3-432-95391-7 .
