Incomitant or paralytic squint
definition and general aspects
etiopathogenesis
- neurogenic paralysis
- myogenic paralysis
symptoms
- diplopia
- false orientation
- dizziness
clinic
- acute phase
- primary and secondary deviation
- compensatory torticollis (or head rotation)
- phase of concomitantization of the deviation
clinical features of oculomotor nerve palsies
Incomitant or paralytic squint
definition and general aspects
etiopathogenesis
- neurogenic paralysis
- myogenic paralysis
symptoms
- diplopia
- false orientation
- dizziness
clinic
- acute phase
- primary and secondary deviation
- compensatory torticollis (or head rotation)
- phase of concomitantization of the deviation
clinical features of oculomotor nerve palsies
- nuclear
- fascicular
- radiculqri
- truncular
Incomitant squint in oculomotor palsies
3rd cranial nerve palsy: congenital / acquired deficits
Paralysis of the IV: congenital / acquired deficits
paralysis of the VI: cogenitic / acquired deficits
double levator paralysis
Incomitant squint in:
fracture (s) of the orbital walls
thyroid myopathy
diabetes and vascular diseases
Diagnosis
- evaluation of the incompleteness
- version evaluation - cover test
- assessment of torticollis
- evaluation of diplopia (red glass, hess screen, coordination test)
- etiopathogenetic clinical diagnosis
therapeutic approach
use of prismatic lenses
surgical therapy
medical therapy (vs causal pathology)
Incomitant deviations and restriction syndromes
definitions and generalities
- Stilling turk Duane syndrome type I, II, III
- brown syndrome
- moebius syndrome
-Congenital muscolare fibrosis
DIAGNOSIS and THERAPY of vertical strabismus
ALPHABETICAL SYNDROMES: etiology and clinical characteristics
NISTAGMUS
Definition and Characteristics (wave type, frequency, amplitude, intensity, direction, symmetrical spatial trajectory, age of onset, neutral point)
Physiological nystagmus
- optokinetic nystagmus
- caloric-induced vestibular nystagmus
- rotatory vestibular nystagmus
- laterality nystagmus
- voluntary nystagmus
- fatigue nystagmus; from an extreme or unsupported gaze
pathological nystagmus
congenital or infantile
- idiopathic congenital nystagmus
- nystagmus due to sensory defect
- latent nystagmus; manifest-latent nystagmus
- spasmus nutans
acquired
- vestibular nystagmus
- neurological nystagmus
- periodic alternating nystagmus
- nystagmus secondary to visual impairment
- spasmus nutans
Therapeutic approach
OCULAR TORCICOLLO
Definition and general aspects
etiopathogenesis
Compensatory stiff necks improve visual function
- from refractive anomalies
- from perimetric anomalies
- from nystagmus (congenital; manifest latent strabismus; in congenital monophthalmos, sensory N, acute nystagmus)
Oculomotor abnormalities of infantile cerebral palsy and ocular torticollis
Eyelid ptosis and abnormal head position or ocular torticollis
compensatory stiff necks in the presence of an incomplete squint
- deficit of the III cranial nerve
- IV cranial nerve deficit
- deficit of the 6th cranial nerve
- parcel muscle fibrosis
- double deficit of the elevators
- Stilling-Turk-Duane syndrome
- Brown's syndrome
- orbital blouw-out
