Lyons Christopher
Department of Ophthalmology and Visual Sciences, University of British Colombia, and the Department of Ophthalmology, BC Children's Hospital, Vancouver, British Columbia, Canada.
Am Orthopt J. 2012;62:61-9. doi: 10.3368/aoj.62.1.61.
Esotropia is the most common form of strabismus seen in clinic. Accommodation is known to be an important precipitating factor, and its management is usually not complex. In this paper, I have reviewed a dozen circumstances in which the presentation was complicated. For some patients, the cause of fleeting symptoms was elusive and had to be determined through careful sensory and motor testing. In others, the presentation was indicative of serious underlying pathology that warranted further investigation. Lastly, restrictive conditions may be erroneously thought to be neurological, and some of these are also discussed. The patients presented include the following problems: fixation switch diplopia, consecutive esotropia unmasking superior oblique palsy, over-corrected myopia, acute nonaccommodative esotropia, comitant esotropia with underlying cerebellar tumor, sixth nerve palsy due to pontine tumor or cavernous pathology, and thyroid strabismus mimicking sixth nerve palsy.
内斜视是临床上最常见的斜视类型。已知调节是一个重要的诱发因素，其治疗通常并不复杂。在本文中，我回顾了十二种临床表现复杂的情况。对于一些患者，短暂症状的原因难以捉摸，必须通过仔细的感觉和运动测试来确定。对于另一些患者，临床表现提示存在严重的潜在病理状况，需要进一步检查。最后，限制性疾病可能被错误地认为是神经性的，本文也讨论了其中一些情况。所呈现的患者包括以下问题：注视转换性复视、连续性内斜视掩盖上斜肌麻痹、近视过度矫正、急性非调节性内斜视、伴有潜在小脑肿瘤的共同性内斜视、因脑桥肿瘤或海绵窦病变导致的第六神经麻痹，以及模仿第六神经麻痹的甲状腺性斜视。
