Case Studies in Ophthalmology
Cases for the Ophthalmology Clerkship
Note to Medical Students on the Ophthalmology Rotation at the University of Iowa:
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Return the printed copy with your answers to Michelle Snyder or Dr. Kemp via campus mail (11290 PFP) or scan as a pdf and email to Michelle at michelle-r-snyder@uiowa.edu or Dr. Kemp at pavlina-kemp@uiowa.edu.
Case #35 Congenital Esotropia
History
A 6 month old child presents to an ophthalmologist with a history of crossed eyes since birth. Her growth and development have been normal and she has not had other medical problems.
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Question #1
What is your differential diagnosis?
Question #2
What tests would you perform in order to arrive at the correct diagnosis?
Question #3
What other characteristics are often associated with congenital esotropia?
Question #4
What diagnostic test(s) would differentiate VIth nerve palsy from congenital esotropia?
Question #5
What surgical procedures could be performed to treat this disorder?
References
Nelson LB, et al. Congenital esotropia. Surv Ophthalmol 1987; 31(6):363-383.
Scott WE, Reese PD, Hirsch CR, Flabetich CA. Surgery for large-angle congenital esotropia: Two vs three and four horizontal muscles. Arch Ophthalmol 1986; 104(3): 374-377.
Kraft SP, Scott WE: Surgery for congential esotropia - An age comparison study . J Ped Ophthalmol & Strabis 1984: 2(2): 57-68.