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Purpose: To compare the macular and nerve fiber layer thicknesses as measured by optical coherence tomography (OCT) in amblyopic and fellow eyes. Methods: Fifty patients with monocular strabismic (n = 25) or anisometropic (n = 25) amblyopia (best corrected visual acuity (BCVA) ranging from 20/40 to 20/400) were included in a prospective cross-sectional descriptive study. A refractive error more than 5 diopters in either eye or an axial length difference between the eyes of more than 1 mm was excluded in the anisometropic group. In all cases, the thickness of the macular area and the peripapillary nerve fiber layer were measured by OCT in both amblyopic and fellow eyes and compared with each other. Results: The mean age of patients was 10 ± 3.1 years (range: 6 to 18 years) in the anisometropic group and 8.9 ± 3.7 years (range: 6 to 18 years) in the strabismic group. In the anisometropic group, the mean macular thickness was significantly increased in the amblyopic eyes (222.6 ± 47.8 μm) versus the fellow eyes (205.6 ± 33.3 μm) ( P = .002), although there was no significant difference observed when comparing with the prepapillary nerve fiber layer ( P = .55). There was no significant correlation of above-mentioned matters in the strabismic group ( P = .07 and .52). Conclusion: A thicker macula was found in anisometropic amblyopic eyes, but the increase of macular thickness in strabismic amblyopic eyes was not significant. Retinal involvement was not observed in the peripapillary nerve fiber layer of amblyopic eyes. [J Pediatr Ophthalmol Strabismus 2013;50(4):218–221.]

Both MCI and BCI were successful in a similar percentage of patients with NLDS. The main advantages of the former technique were simple insertion and easy removal of the tube.

Purpose: To evaluate the factors affecting improvement of stereopsis following successful surgical correction of childhood strabismus in adults. Methods: In a prospective study, consecutive patients with childhood-onset, comitant, horizontal, constant strabismus; stereoacuity of more than 480 seconds of arc in TNO stereo test (absent stereopsis in TNO); and who had successful postoperative alignment (within 10 prism diopters [PD] of orthotropia) were enrolled. Postoperative stereopsis testing was performed using the TNO stereo test at 3 months after surgery.Results: A total of 34 patients (20 exotropes and 14 esotropes) were included. The mean age at the time of surgery was 26.08 ± 10.53 years (range, 14-53 years). Stereopsis was improved in 8 of 34 patients (23.5%). Postoperative alignment had influence on improvement of stereopsis; 38.1% of patients who had orthotropia gained stereopsis, whereas none of patients who had horizontal heterotropia (esotropia or exotropia) of 10 PD or less gained stereopsis (p = 0.01). Misalignment of 10 years' duration or longer did not preclude the development of postoperative stereoacuity (p = 0.31). There was a statistically insignificant increase in improvement of stereopsis in nonamblyopic group (30.4%) compared with amblyopic group (9.1%) (p = 0.22). Also, there was a statistically insignificant increase in improvement of stereopsis in exotropes (35%) compared with esotropes (7.1%) (p = 0.1). The angle of preoperative deviation had no influence on improvement of stereopsis (p = 0.44). Conclusion: A postoperative correction of orthotropia was the only predictive factor for improvement of stereopsis in adults with childhood strabismus.

Purpose: To assess the effect of experimental anisometropia and monovision on stereopsis using the Titmus, Randot, and TNO stereoacuity tests. Methods: Sixty adult volunteers were enrolled in the present study. Four different types of anisometropia—myopia, hyperopia, and astigmatism (both 90° and 45°)—were induced by placing trial lenses over the dominant eye (from 3 to 1 D). Stereoacuity was measured using the Titmus, Randot, and TNO tests. Results: In all the anisometropia types, stereopsis deteriorated with increase in anisometropia in the three stereoacuity tests performed ( P < 0.001). The largest decrease in stereopsis was attributed to 3 D myopic anisometropia—6.51 ± 2.10, 6.59 ± 2.35, and 7.36 ± 1.89 arc seconds in Titmus circles, Randot circles, and TNO, respectively. Minimal change in stereopsis was observed in 1 D astigmatism of 45°. Conclusion: Any type of anisometropia may reduce stereoacuity; this reduction is most noticeable with myopic anisometropia, especially in the TNO test, probably due to the lack of monocular cues.

Introduction: The surgical correction of anomalous movement such as upshoot in Duane syndrome is challenging. Lateral rectus muscle disinsertion and reattachment to the lateral orbital wall is a new approach used to minimize or eliminate the effects of co-contraction including globe retraction, palpebral fissure narrowing and anomalous vertical movement.

Purpose To evaluate the results of augmented vertical rectus muscle transposition (VRT) with intraoperative botulinum toxin (BTX) for complete and chronic sixth nerve palsy. Methods During a 10-year period (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014) all patients with chronic and complete sixth nerve palsy and contracted medial rectus (MR) who underwent augmented VRT and BTX injection into the MR enrolled in this study. Results In total, 29 patients (5 bilateral) were enrolled in this study. Preoperative deviation was 45 ± 17.5 Prism Diopter (PD), which was improved to − 3.1 ± 13.2 after the operation (Po0.001). Mean preoperative and postoperative abduction limitation was − 4.4 ± 1.1 and − 1.8 ± 0.9, respectively (Po0.001). The success rate was 76% (deviation within 10 PD of orthotropia). Four patients (13.7%) had hypotropia. In 19 patients with preoperative deviation ≤ 45 PD, four patients had consecutive exotropia. Conclusion Intraoperative BTX injection with augmented vertical rectus transposition is an effective procedure. In deviation ≤ 45 there is a risk of overcorrection.

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