Abstract :
Material and Methods: The study was conducted at Pediatric Ophthalmology and strabismus clinic
at our tertiary care institute PGIMS, Rohtak. The study was a descriptive pilot study which was
conducted between January 2017 to April 2019. All patients who reported to pediatric ophthalmology and
strabismus clinic, PGIMS, Rohtak, diagnosed as Congenital fibrosis of EOM, Duane’s retraction syndrome,
Mobius syndrome, Congenital strabismus with abnormal vertical movements, MEDs and variants of
Dysinnervational disorders were included in our study.
Results: In the study a total of 25 cases were taken with 22 cases having a follow up of 6 months, with
71% cases being females and rest being males, 27% cases had bilateral involvement, 32% had left and 41%
had right eye involvement. 56% had strabismic amblyopia, 11% had anisometropic and rest had visual axis
obscuration. 10 cases from the total were treated with surgery and 4 were managed conservatively, a follow
up of >6 months was taken and results were noted.
Discussion: Of the multiple observations made through this study some of the most important ones were
that patients with CFEOM have variable angle strabismus mainly Exotropia with hypertropia , Muscle
hypoplasia with displaced scleral insertions were seen, two staged surgical correction of remnant muscles
resulted in good ocular alignment, AHP was frequently present, there was association of CCDD’s with
complex strabismus, predominant vertical ocular motility defects helped as a tool for diagnosing variants
of CCDD’s, cosmetic alignment with correction of face turn helped a long way in restoring self confidence
of patients, Congenital MED with innervational pathology was included and Knapp’s procedure has proved
to be effective in treating strabismus, AHP, ocular elevation.
Conclusion: Classification and unification of congenital disorders of ocular motility continues to evolve
and unlock the complexity of mechanism of etiopathogenesis of CCDD, and advanced imaging is opening
new doors of managing these cases successfully each day, further research in genetic basis of this disease
complex can yield us better results in future.
Keyword :
Misinnervation, Upshoot, Abnormal head posture, Globe retraction, Ocular misalignment.