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Bilateral Inferior Rectus Muscle Aplasia, Severe Hypertropia, Deprivation Amblyopia An infant was referred to BPEI for strabismus/oculoplastic evaluation. They were born prematurely at 32 weeks of gestation with a previous surgical history notable for superior rectus tenotomy. The patient presented…

Blunt Right Eye Trauma with a Transected Inferior Rectus Muscle Resulting in Severe Right Hypertropia An adult patient was transferred to BPEI ER after suffering right eye trauma while using a pressure washer machine. Patient reported his right eye had been bleeding and swollen since the accident. …

Brown Syndrome A patient was diagnosed with thyroid eye disease (TED) 2 years before presenting to our clinic. He complained of horizontal and vertical diplopia. The diplopia was constant and affected distance vision only. The patient was previously treated with teprotumumab. His exam was notable f…

Patient with Brown Syndrome with images and videos showing for esotropia which was worse in left gaze, hypotropia of left eye worse in right gaze and upgaze accompanied by limited elevation OS in adduction and incyclotorsion left eye, and restriction of extraocular movement of both eyes.

RetCam photo with a bullous exudative retinal detachment. Angiography shows area of engorged vessels, telangiectasias and neovascularization. Ultrasound with moderate dense vitreous opacities and no calcifications. Surgery with external drainage was required for treatment.

Coats' Plus Disease An infant born prematurely via emergency cesarean section at 27-weeks due to IUGR and fetal distress weighting 650 g was referred for the evaluation of incomplete vascularization of the retina. After birth, the patient spent 117 days in the neonatal intensive care unit (NICU), w…

Coloboma associated with a systemic syndrome.

Combined Hamartoma of the Retina and Retinal Pigment Epithelium A 19-month-old girl with an unremarkable prenatal and infantile history presented with esotropia of the left eye and was found to have a vascularized mass concerning for retinoblastoma. Examination under anesthesia revealed a charcoal …

Community-Acquired Methicillin-Resistant Staphylococcus Aureus (MRSA) Caused Episcleral Mass Resembling Granuloma A patient underwent bilateral medial rectus recession for a history of infantile esotropia. Ten days prior to the surgery, she developed a skin lesion on her forearm and was placed on c…

Esotropic Duane Retraction Syndrome, Right Eye An adult patient was referred to our service for strabismus evaluation due to crossing of the eyes. Patient complained of having difficulty looking towards the right side, which had occurred since childhood. The patient also reported moderate to severe…

Familial Exudative Vitreoretinopathy A child with a history of full-term birth complicated by arrest of descent and resolved neonatal seizure with normal MRI and EEG was referred for evaluation of nystagmus. An examination under anesthesia was required, during which an electroretinogram demonstrate…

Familial Exudative Vitreoretinopathy and Retinopathy of Prematurity An infant underwent ophthalmic examination. Born at 32 weeks, the infant weighed 680 grams and received high-flow nasal cannula for respiratory distress of the newborn. Dilated fundus examination of the right eye revealed periphera…

Heavy Eye Syndrome/Adult Onset Esotropia Secondary to High Axial Myopia A patient with history of amblyopia right eye, and no previous ocular surgery or childhood strabismus presents with large angle esotropia and hypotropia. Exam was notable for hand movements vision in the right eye and 20/20 in …

Hermansky-Pudlak Syndrome An infant was brought to the emergency department by his mother referred from his pediatrician after a routine well-child visit. Parents had noticed severe light sensitivity, but patient was otherwise developing well. Patient grimaced to light in both eyes but had poor fix…

Juvenile X-linked Retinoschisis A pediatric patient with a past medical history of Kawasaki disease presents for retinal evaluation of reported vitreous hemorrhage in the right eye and retinal detachment in the left eye. The visual acuity was 20/200 in the right eye and 20/800 in the left eye. The …

Knobloch Syndrome An infant presented to the eye clinic with nystagmus. The patient underwent examination. Initial eye examination revealed horizontal nystagmus, a midline occipital scalp lesion, hypoplastic macula in both eyes, and high myopia (greater than -15.0 D in both eyes). Given a family hi…

Marfan Syndrome with Ectopia Lentis A young child presented to the ophthalmology clinic with blurry vision. Slit lamp examination was notable for superotemporally subluxed lenses in both eyes, along with a tall slender body frame. Due to these findings, the patient was referred to a geneticist and …

Optic nerve cyst (first image) that over time revealed an optic nerve coloboma (second image).

Orbital Myiasis A patient with PMHx of HTN and POHx of basal cell carcinoma involving the right lateral nasal wall s/p wide resection and orbital exenteration with subsequent reconstruction (complicated by a chronic open wound along the superior lateral nasal wall extending into the right frontal/e…

In this module, we will look at:




Extraocular Muscle


Introduction to Pediatric Ophthalmology