Diagnosis and Treatment of Thyroid Related Abduction Deficits

Abstract

Abduction deficits in thyroid related strabismus may be due to three causes: isolated inelasticity of the inferior rectus muscle, combination of inelasticity of inferior and medial rectus and isolated inelasticity of medial rectus. Diagnosis is made: in the first situation the presence of small esotropia an modest limitation of abduction, hypotropia, and intraoperatively the release of abduction positive test after inferior rectus disinsertion; in the second situation the presence of large esotropia and marked limitation of abduction, in addition to hypotropia, and intraoperatively the persistence of positiveness of abduction forced test after disinsertion of medial rectus. Treatment should be: in the first situation inferior rectus recession; in the second situation inferior and medial rectus recession; in the third situation medial rectus recession.

• thyroid eye disease
• strabismus
• forced duction tests
• surgery