Complex Ocular Motility Disorders in Children

  • Michael C. Brodsky


A number of complex ocular motility disorders are discussed in this chapter. The diversity of these conditions reflects the need for the ophthalmologist to maintain a broad working knowledge of pediatric neurologic disorders along with their ocular motor manifestations. Some clinical features of these conditions (e.g., congenital ocular motor apraxia, congenital fibrosis syndrome) are sufficiently unique that the diagnosis can be established solely on the basis of the clinical appearance. Other disorders either show overlapping manifestations or effectively masquerade as other entities. Unique features of some conditions, such as conjugate ocular torsion in patients with skew deviation, are considered worthy of emphasis because they significantly expand the differential diagnosis. Indeed, assessment of objective torsion (and subjective torsion when possible) is a necessary component of any comprehensive strabismological evaluation [422]. Correction of coexisting torsion can be integrated into the surgical plan, except when the torsion serves a compensatory function, as in patients with skew deviation.


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