Dr.ANNU JOON
Purpose:To report a family with 3 affected generations of CFEOM type1,showcasing abnormal insertions of EOM and poor surgical results.
Methods: A family with mirror image motility disorder present since birth was evaluated clinically,the proband 13 year old girl was put under the knife for correction of bilateral hypotropia
Results-Patient had bilateral ptosis,bilateral hypotropia with gross motility restriction,no horizontal tropia.Similar presentation was noted in sister,mother,maternal uncle and grandfather.At surgery, right IR was recessed 10mm.In left eye;IR, anterior ciliary vessels to IR and inferior vortex vein could not be identified in normal location. MR, IR and LR were abnormally inserted.Surgery was abandoned. No motility improvement or PP misalignment was noted despite large recession of IR OD.
Conclusion:CFEOMs are a surgical challenge with modest surgical outcomes.Abnormal insertion,absence of EOM should be factored in while dealing with such complex motility disorders.
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