ArticleJournal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus2015
Heavy eye syndrome versus sagging eye syndrome in high myopia.
Article in Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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Who cites it
32 citing papers in PubMed.
- Dissociation between globe shape-induced rectus muscle pulley displacement and abduction limitation in patients aged 40 years and older with high myopic strabismus.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026Article
- Cyclotorsion as a structural and functional biomarker of ocular and neuroophthalmic diseases.Acta biochimica Polonica · 2026Review
- Prevalence and prognosis of sagging eye syndrome in Japanese population.Japanese journal of ophthalmology · 2025Observational
- Relationships between tilt angles of rectus muscles and positions of rectus muscle pulleys in patients with sagging eye syndrome.Japanese journal of ophthalmology · 2025Article
- Relationships among eye dimensions in magnetic resonance images by sex, age, and strabismus type in Japanese patients with acquired strabismus and high myopia.Japanese journal of ophthalmology · 2024Article
- [Differential diagnosis of vertical strabismus in the elderly].Die Ophthalmologie · 2024Review
- Article
- Heavy eye syndrome in a myopic patient with prior scleral buckle surgery for rhegmatogenous retinal detachment: Differential diagnosis and management.American journal of ophthalmology case reports · 2022Article
- Retropupillary Iris Fixation of an Artisan Myopia Lens for Intraocular Lens Dislocation and Aphakia in Eyes with Extremely High Myopia: A Case Series and a Literature Review.Ophthalmology and therapy · 2022Article
- Sagging eye syndrome.Japanese journal of ophthalmology · 2021Review
- Etiology and Clinical Features of Diplopia in South China: Analysis of 303 Cases.Frontiers in neurology · 2021Article
- Article
- Clinical Features of Crowded Orbital Syndrome on Magnetic Resonance Imaging.Neuro-ophthalmology (Aeolus Press) · 2021Article
- Standard coronal orbital magnetic resonance imaging is an effective technique for diagnosing sagging eye syndrome.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2020Article
- Inferior rectus displacement in heavy eye syndrome and sagging eye syndrome.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2020Article
- Shape analysis of rectus extraocular muscles with age and axial length using anterior segment optical coherence tomography.PloS one · 2020Article
- Prevalence of Sagging Eye Syndrome in Adults with Binocular Diplopia.American journal of ophthalmology · 2020Article
- Rectus Extraocular Muscle Paths and Staphylomata in High Myopia.American journal of ophthalmology · 2019Article
- Lateral rectus sag and recurrent esotropia in children.Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2019Article
- Magnetic resonance imaging findings of age-related distance esotropia in Japanese patients with high myopia.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2019Article
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Abstract
backgroundHeavy eye syndrome (HES) presents with esotropia and limited abduction due to superotemporal globe shift relative to the extraocular muscles. Sagging eye syndrome (SES) was originally described in nonmyopic patients exhibiting distance esotropia and cyclovertical strabismus with limited supraduction due to lateral rectus muscle inferodisplacement caused by degeneration of the lateral rectus-superior rectus (LR-SR) band. We hypothesized that SES might also cause strabismus in high myopia.
methodsEleven strabismic subjects with high myopia underwent ophthalmological examination and orbital magnetic resonance imaging (MRI) to assess quantitative orbital anatomy.
resultsOf 11 subjects, 5 had HES; 6, SES. Mean axial length in subjects with HES was 32 ± 5 mm; in subjects with SES, 32 ± 6 mm. Average distance esotropia in subjects with HES was 61(Δ) ± 39(Δ); hypotropia was 26(Δ) ± 21(Δ). Average distance esotropia in subjects with SES was 23(Δ) ± 57(Δ); hypertropia was 2(Δ) ± 2(Δ). All 5 subjects with HES had superotemporal globe prolapse; the LR-SR band was thinned in 6 orbits and ruptured in 2. The mean angle between the lateral rectus and superior rectus muscles in HES was 121° ± 7°. In SES the LR-SR band was thinned in 7 orbits and ruptured in 5, with superotemporal soft tissue prolapse. The mean angle between the lateral rectus and superior rectus muscles was 104° ± 11°, significantly less than in HES (P < 0.001).
conclusionsSES occurs in highly myopic patients who also exhibit less relative globe dislocation than in HES. Unlike HES, SES exhibits superotemporal soft tissue prolapse that may limit superotemporal globe shift. The distinction is important because surgery for HES uniquely requires creation of a surgical connection between the superior rectus and lateral rectus muscles, whereas SES may be treated with conventional surgery. SES can cause strabismus in high axial myopia. Orbital MRI is useful in differentiating SES from HES.
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