An 8mm recession of the right lateral rectus
muscle with 2mm upward shifting of lateral rectus
insertion and medial rectus resection of 7mm was performed.
The same patients also developed transient lateral rectus
palsy and diplopia on ipsilateral lateral gaze that were successfully managed with the help of taping of eyelid and physiotherapy and could be discharged home after 10 days.
Computed tomography scan showing enlargement of the right superior and lateral rectus
muscles, which are commonly inflamed in idiopathic orbital inflammation.
Patients with exotropia of 60-80 PD underwent lateral rectus
recession of 8-10 mm and medial rectus resection of 7-9 mm under peribulbar anaesthesia.
Also, 1(2%) had keratomalacia, 1(2%) patient requiring grafting had Bowen's disease and in 1(2%) patient there was exposed lateral rectus
Differential diagnosis includes age-related calcifications involving the insertion of the lateral rectus
muscles, an extraocular retinoblastoma extension, or an intraorbital foreign body.
We also calculated the sum thickness of the inferior, medial, superior, and lateral rectus
. The thickness of EOM was significantly increased in both GO groups as compared to that in the control (both P < 0.01), and the thickness of EOM was significantly increased in the responsive group than in the unresponsive group (P < 0.05).
Distribution of muscle involvements Involved muscles LOOM SEOM LOOM+SEOM Single muscle 2/3 (66.6%) 1/2 (50%) 3/5 (60%) Multiple muscles 1/3 (33.3%) 1/2 (50%) 2/5 (40%) Bilateral 1/3 (33.3%) - 1/5 (20%) Medial rectus 2/3 (66.6%) 1/2 (50%) 3/5 (60%) Inferior rectus - 1/2 (50%) 1/5 (20%) Lateral rectus
1/3 (33.3%) 2/2 (100%) 3/5 (60%) Superior rectus - 1/2 (50%) 1/5 (20%) LOOM: limited oligosymptomatic ocular myositis; SEOM: severe exophthalmic ocular myositis
(4) In the Knapp procedure, all the tendons of the medial and lateral rectus
muscles are transposed to the insertion of the superior rectus muscle, whereas in the partial Knapp procedure, half of the tendons of the medial and lateral rectus
muscles are transposed to the insertion of the superior rectus muscle.
* eye abducted in primary position due to unopposed action of the lateral rectus
The abducent nerve innervates the lateral rectus
muscle which abducts the eye (move away from the midline).
The patient had bilateral lateral rectus
paresis and bilateral diplopia in the lateral gaze.