A Case of Aplasia of the Inferior Rectus Muscle With an Atypical Bielschowsky's Head Tilt Test Result

DOI 4 References
  • Kodani Koutarou
    Department of Ophthalmology, Miyazaki Medical College Hospital
  • Chuman Hideki
    Department of Ophthalmology, Miyazaki Medical College Hospital
  • Kawano Naoko
    Department of Ophthalmology, Miyazaki Medical College Hospital
  • Ikeda Fukumi
    Department of Ophthalmology, Miyazaki Medical College Hospital
  • Naoi Nobuhisa
    Department of Ophthalmology, Miyazaki Medical College Hospital

Bibliographic Information

Other Title
  • Ｂｉｅｌｓｃｈｏｗｓｋｙ頭部傾斜試験にて非傾斜側眼が上転した先天下直筋欠損の１例

Search this article

Description

  A 10-month-old boy was referred to us because of the head tilting to the right side. He was suspected of a left congenital superior oblique palsy. At the first visit, visual acuity could not be measured and cycloplegic refractions were+2.0 D = cyl−1.00 DA×180 for the right eye and +1.5 D = cyl−0.75 DA×180 for the left eye. When the head was turned towards the left shoulder in the Bielschowsky’s head tilt test, increased right hypertropia was noticed. A brain MRI showed aplasia of the right inferior rectus muscle as well as hypoplasia of the left inferior rectus muscle. In the right eye, we performed the horizontal rectus muscle transposition by moving the medial and lateral rectus muscles to the insertion site of the inferior rectus muscle. Absence of the right inferior rectus muscle was confirmed during the surgery. <BR>  After the procedure, his head position was normal. However, the procedure induced significant astigmatism in the right eye and he developed refractive amblyopia. At the age of 3, visual acuity and cycloplegic refraction were 0.3×+4.0 D = cyl−3.00 DA×180 for the right eye and 1.0×+1.0 D for the left eye. Refractive corrections by glasses and occlusion therapy were started, and visual acuity of 1.2 was obtained 18 months later. <BR>  When the eye of the unaffected side appeared to be elevated in the Bielschowsky’s head tilt test, the possibility of congenital aplasia of the inferior rectus muscle should be considered. Although horizontal rectus muscle transposition is an effective procedure, it may induce astigmatism. Therefore, visual acuity and refractive errors should be closely followed after surgery.

Journal

References(4)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top