ArticleJournal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus2014
The Apt Lecture. Connective tissues reflect different mechanisms of strabismus over the life span.
Article in Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 30 citations in OpenAlex.
- Prevalence and prognosis of sagging eye syndrome in Japanese population.Japanese journal of ophthalmology · 2025Observational
- Surgery for Esotropia in a Case of Nanophthalmos.Cureus · 2024Article
- Lateral rectus pulley concerning the orbital wall. Area of a stereotyped bony insertion.Heliyon · 2024Article
- Range of forced cyclorotation in superior oblique palsy and V-pattern strabismus.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2021Article
- Pseudo inferior oblique overaction, clinical findings, mechanism, and surgical outcomes.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2019Article
- Knobby Eye Syndrome.Strabismus · 2018Article
- The biomechanical significance of pulley on binocular vision.Biomedical engineering online · 2016Article
- Heavy eye syndrome versus sagging eye syndrome in high myopia.Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2015Article
- Cross-coupled eye movement supports neural origin of pattern strabismus.Investigative ophthalmology & visual science · 2015Article
- Age related strabismus.Romanian journal of ophthalmologyReview
- Orbital magnetic resonance imaging is useful in age-related distance esotropia.Journal of optometryArticle
- The Role of Extraocular Muscle Pulleys in Incomitant Non-Paralytic Strabismus.Middle East African journal of ophthalmologyReview
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1 author at 1 institution in 1 country.
Funding
Abstract
backgroundConnective tissue pulleys determine extraocular muscle force directions and pulley heterotopy can induce strabismus. The etiology and type of pulley abnormalities vary with patient age, resulting in different but predictable types presentations of strabismus.
methodsMagnetic resonance imaging (MRI) was obtained in 95 patients with pulley heterotopy, of whom 56 had childhood-onset pattern strabismus, and was compared with published data on 28 patients aged 69 ± 12 years who had sagging eye syndrome. Control data were from age-matched normal controls with no strabismus.
resultsPatients with childhood-onset strabismus had intact lateral rectus-superior rectus band ligaments and straight extraocular muscle paths but exhibited pulley array A pattern-associated incyclorotation or V pattern-associated excyclorotation. Rectus transposition surgery collapsed patterns. Patients with sagging eye syndrome exhibited blepharoptosis, superior sulcus defect, and inferolateral displacement of rectus pulleys with elongation of extraocular muscles that followed curved paths. Symmetrical lateral rectus pulley sag was associated with divergence paralysis esotropia; asymmetrical sag > 1 mm, with cyclovertical strabismus. Both lateral rectus resection and medial rectus recession treated divergence paralysis esotropia. Partial vertical rectus tenotomy treated cyclovertical strabismus.
conclusionsChildhood onset pulley abnormalities are associated with A or V pattern strabismus and external anatomical features suggest that these pulley defects are probably congenital. Adult onset pulley defects commonly result from age-related tissue involution and external features such as adnexal laxity are also helpful in recognizing involution as a possible etiology of strabismus.
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