Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, India.
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, India.
Med Hypotheses. 2019 Feb;123:115-117. doi: 10.1016/j.mehy.2019.01.011. Epub 2019 Jan 16.
The assessment of nature and the extent of extraocular muscle injuries during initial visit in ocular emergencies is of paramount importance to avoid/minimize the subsequent need for strabismus surgery. Based on our experience in managing acute globe and orbital injuries and cases of strabismus, we propose the probable mechanism involved in the occurrence of extraocular muscle flap tear and a complete rupture of the muscle. During high-velocity injuries when the forces are equally transmitted along the orbital bony framework and the globe, then due to differential shearing forces created between the global and the orbital fibres leads to a flap tear. In the second scenario, if the forces are only directed along the bony framework, then the globe continues to be in continuous motion leading to increased tension between the muscles and the globe. Thus the weaker portions between these two structures are at risk of complete separation, that is along the insertion of muscle onto the globe or the musculotendinous portion.
在眼科急症的初次就诊中，评估眼外肌损伤的性质和程度至关重要，可避免/减少后续斜视手术的需求。基于我们在处理急性眼球和眼眶损伤以及斜视病例方面的经验，我们提出了眼外肌瓣撕裂和完全断裂的可能发生机制。在高速损伤中，当力沿眶骨框架和眼球均匀传递时，由于眼球纤维和眶纤维之间产生的差异剪切力，导致瓣撕裂。在第二种情况下，如果力仅沿骨框架定向，则眼球继续连续运动，导致肌肉和眼球之间的张力增加。因此，这两个结构之间较弱的部分有完全分离的风险，即沿着肌肉插入眼球或肌肌腱部分。
