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Consecutive strabismus
Strabismus
Key Points
- •Consecutive exotropia (after esotropia surgery) is the most common form - occurs in 10–20% of infantile esotropia cases, with rates rising with longer follow-up.
- •The most common mechanism for late consecutive exotropia is progressive divergent drift after bilateral medial rectus recession - driven by loss of MR force and poor binocular fusion.
- •Forced duction testing is essential before re-operation to distinguish restrictive (scarring) from paretic (slipped/weak muscle) causes.
- •Surgical options for consecutive exotropia include MR advancement, LR recession, or both; operate on previously unoperated muscles where possible.
- •Botulinum toxin injection is a useful non-surgical option for small-to-moderate consecutive deviations (2.5–5 units to the overacting muscle).
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17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations