Dr. Shubhangi Bhave, B03805
A 7 years old male patient presented to us in 2009 with history of deviation of eyes since 5 months of his age. He again came to us in 2014. Vision was 6/6 and N6 in both eyes. There was no significant refractive error. Eyes appeared prominent. Exophthalmometry was done 12-13 mm in both eyes. Anterior segment BE were normal. Fundi BE were normal. AHP- Face turn to left. Right XT PBCT 40-45 PD Exotropia for distance and near in primary position .Ocular Movements show RE adduction deficit gr III. Widening of palpabral aperture on RE Adduction. No significant narrowing on abduction . Vertical movements were normal. Differential Diagnosis1)Inverse Duanes Retraction syndrome2)Congenital Cranial Dysinnervation Disorders Variant3)Hypoplastic Right Medial Rectus .CT Scan of Orbit done. The Muscle thickness was reported to be normal. .We decided to do Y-Split of RLR and RMR recession. Post operatively patients exotropia improved significantly with improvement in head posture.