PARALYTIC SQUINT KANISHK DEEP SHARMA ROLL NO. 50 Uncoordinated eye movement Angle of squint varies Motor imbalance ETIOLOGY Lesion of nerve Lesion of muscles Lesions due to Injury Inflammation-syphilis, disseminated sclerosis Vascular diseases-hemorrhage, aneurysm,arteriosclerosis Neoplasms-brain tumor Toxins-alcohol, lead, carbon monoxide Degeneration-chronic nuclear ophthalmoplegia Myasthenia gravis SYMPTOMS DIPLOPIA In field of action of paralyzed muscle Long duration- suppression of false image Vertigo & nausea Action required towards paralysed muscle False projection Binocular diplopia Secondry deviation Defective ocular motility Complementary head postures Attempt to lessen diplopia Head tilt to avoid torsion SEQUALAE Weakness of paretic muscle Overacting contralateral synergistic muscle Inhibitory palsy of contralateral antagonist TESTS Record of visual acuity Ocular motility Perimetry Inspection of compensatory head postures Diplopia charting Dark room procedure Armstrong's glasses 4ft distance, fine linear light Primary & other positions of gaze measured Hess charting Explains muscle paralysis & pathological sequlae Field of binocular fixation Forced duction test MANAGEMENT Treatment of cause Conservative measures Vit B complex, systemic steroids Diplopia treatment Occluder on affected eye SURGERIES Muscle weakening procedure Recession, marginal myotomy, myectomy Muscle strengthening procedures Resection, tucking advancement Changing direction of muscle action THANK YOU

1. PARALYTIC SQUINT
KANISHK DEEP SHARMA
ROLL NO. 50

2. • Uncoordinated eye movement
• Angle of squint varies
• Motor imbalance

3. ETIOLOGY
1. Lesion of nerve
2. Lesion of muscles

4. Lesions due to
1. Injury
2. Inflammation-syphilis, disseminated sclerosis
3. Vascular diseases-hemorrhage,
aneurysm,arteriosclerosis
4. Neoplasms-brain tumor
5. Toxins-alcohol, lead, carbon monoxide
6. Degeneration-chronic nuclear ophthalmoplegia
7. Myasthenia gravis

5. SYMPTOMS
1. DIPLOPIA
– In field of action of paralyzed muscle
– Long duration- suppression of false image
2. Vertigo & nausea
– Action required towards paralysed muscle
3. False projection
– Binocular diplopia
– Secondry deviation

6. 4. Defective ocular motility
5. Complementary head postures
– Attempt to lessen diplopia
– Head tilt to avoid torsion

7. SEQUALAE
• Weakness of paretic muscle
• Overacting contralateral synergistic muscle
• Inhibitory palsy of contralateral antagonist

8. TESTS
1. Record of visual acuity
2. Ocular motility
– Perimetry
3. Inspection of compensatory head postures

9. 4. Diplopia charting
– Dark room procedure
– Armstrong's glasses
– 4ft distance, fine linear light
– Primary & other positions of gaze measured

10. 5. Hess charting
– Explains muscle paralysis & pathological sequlae

11. 6. Field of binocular fixation
7. Forced duction test

12. MANAGEMENT
1. Treatment of cause
2. Conservative measures
– Vit B complex, systemic steroids
3. Diplopia treatment
– Occluder on affected eye

13. SURGERIES
1. Muscle weakening procedure
– Recession, marginal myotomy, myectomy
2. Muscle strengthening procedures
– Resection, tucking advancement
3. Changing direction of muscle action

14. THANK YOU