| V-Pattern Esotropia with Bilateral Inferior Oblique Overaction | |
| A V-pattern is defined as the eyes converging more than 15 diopters in moving from upgaze to downgaze. The eyes are seen to be more exotropic or less esotropic in upgaze. In downgaze, the eyes are less exotropic or more esotropic. V-patterns may or may not be associated with oblique muscle overaction. If overaction is present, it will be seen both on duction testing in the direction of the primary action of the oblique muscle in question and also as a hypertropia in horizontal gaze. In this patient, the V-pattern is felt to be secondary to inferior oblique muscle overaction, which is acting primarily as an abductor in upgaze, causing the eyes to diverge more than in downgaze. Primary gaze: This young patient is esotropic in primary gaze. She is fixing with her right eye and the left eye is clearly turned in towards the nose. The light reflexes are not symmetrical. Down-gaze: The esotropia is much greater than in down-gaze than up-gaze, creating the "point" of the V-pattern even though the patient looks orthophoric. Upgaze: The V-pattern is felt to be secondary to inferior oblique muscle overaction, which is acting primarily as an abductor in upgaze, causing the eyes to diverge more in upgaze than in downgaze. Thus, this patient looks exotropic in this photograph. Right and left gaze: V-patterns may or may not be associated with oblique muscle overaction Here the right and left inferior oblique muscle show a 3+ overaction/hypertropia in right/left gaze. | |
| Lin, Alice, M.D., Duke Univ.¦2, Durham, USA | |
| H50.0 | |
| Strabismus, Ocular Motility Disorders -> Pattern Deviation -> V-pattern Esotropia with Bilateral Inferior Oblique Overaction | |
| 7890 |
|
|||||||||||||||
|
V-Pattern Esotropia with Bilateral Inferior Oblique Overaction-------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- |
|
|||||||||||||