By Edward L. Raab, MD, JD
Examines the scientific beneficial properties, analysis and remedy of esodeviations and exodeviations, horizontal and vertical deviations, amblyopia and exact sorts of strabismus. Discusses the entire variety of pediatric ocular issues, extraocular muscle anatomy, motor and sensory body structure and the way to set up rapport with little ones in the course of an ocular exam. includes a variety of pictures, together with colour pictures. lately revised 2010 2011.
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Additional resources for 2011-2012 Basic and Clinical Science Course, Section 6: Pediatric Ophthalomology and Strabismus (Basic & Clinical Science Course)
16 • Pediatric Ophthalmology and Strabismus Superior oblique tendon \ Levator palpebrae superioris muscle -t-- --: Trochlea - --11- Superior rectus tendon Medial rectus tendon Inferior oblique muscle Figure 2·3 Lateral rectus tendon "-- Extraocular muscles, frontal composite view, left eye. -4- lnferior rectus tendon (Reproduced with permission from Dutton JJ. Atlas of Clin ical and Surgical Orbital Anatomy. ) sup erioris muscle becomes an aponeurosis in the region of the superi or fornix. This muscle has both a cutaneous and a tarsal insertion.
2nd ed. ) CHAPTER 2: Anatomy of the Extraocular Mu scles and Their Fascia . 15 peripheral ones (Fig 2-2). The function of the troch lea is to red irect the tendon inferiorly, posteriorly, and laterall y, for ming an angle of 5 10 with the visual ax is of the eye in primary position (see Chapter 3, Fig 3-6). The tendon penetrates the Teno n capsule 2 mm nasally and 5 mm posteri o rl y to the nasal insertion of th e superior rectus muscle. PaSSing und er the superior rectus muscle. the tendon inserts in the posterosuperior quadrant of the eyeball , almost or ent irely laterall y to the mid ve rti cal plane or center of rotation.
This makes surgery on the medial rectus less complicated. but means that there is neither a point of reference if the surgeon becomes disoriented nor a point of attachment if the muscle is lost. 13 14 • Pediatric Ophthalmology and Strabismus Vertical Rectus Muscles The vertical rectus muscles are the superior and inferior rectus muscles. The superior rectus muscle originates from the annulus of Zinn and cou rses anteriorly> upward over the eyeball, and laterally, forming an angle of 23° with the visual axis of the eye in primary position (Fig 2~1; see also Chapter 3, Fig 3~4).