Posters

Acquired convergent strabismus fixus in a myopic elderly Filipino male: a case report

Poster Details

First Author: K.Locaylocay PHILIPPINES

Co Author(s):    P. Villa                    

Abstract Details

Purpose:

To present a case of acquired strabismus fixus (SF) in an elderly Filipino male with progressive myopia and to describe the pathophysiology, clinical manifestations, imaging findings, and management of myopic SF.

Setting:

The patient or case was seen and managed at the outpatient clinic of a tertiary hospital.

Methods:

This is a case report on SF in an elderly Filipino male with progressive myopia since childhood who acquired esotropia in adulthood progressing to convergent SF. Both Pubmed and local databases were used to review the current literature on SF. Data was then correlated to the patient’s case in order to describe the epidemiology, pathophysiology, clinical manifestations, imaging findings and the management of SF.

Results:

SF is a rare oculomotor abnormality that may be acquired with myopia. A 65-year-old male presented with a history of progressive myopia (-17.00 Right; -7.00 Left) with convergent strabismus fixus of >100 prism diopters. Magnetic resonance imaging of the orbits showed bilateral atrophic lateral rectus muscle insertions and superotemporal displacement of the right globe hence the greater esodeviation on right. These findings were consistent with previous imaging studies of patients with myopic SF. Surgical treatment was attempted to improve visual acuity of the right eye given that the fixating left eye has already undergone vitrectomy.

Conclusions:

Early detection and prompt treatment is key to improving the surgical outcome and visual prognosis of myopic strabismus fixus. In this case, the delayed treatment could have caused severe fibrosis that transposition and recession or disinsertion procedures were no longer effective. It is also important to educate and advise patients with pathologic myopia about the possibility of strabismus fixus for regular follow-up and timely management.

Financial Disclosure:

None