Shehla Rubab.
Globe fixation to manage large angle esotropia after 6th nerve palsy.
Al-Shifa J Ophthalmol Jul ;1(2):60-3.

Purpose: To present a technique of globe fixation to restore ocular alignment in primary position in a case of 6th nerve palsy. Study Design: Case report Method: A young male presented with large angle esotropia after 6th nerve palsy. Ocular alignment could not be achieved after multiple strabismus surgeries. Consequently the globe was fixed to the lateral orbital wall to achieve well aligned eyes resulting in better cosmesis and binocular vision in the primary position of gaze. Discussion: Jensen procedure with recession of medial rectus muscle is a procedure of choice in case of total 6th nerve palsy but under-correction or recurrence of deviation can occur in certain cases. Ocular alignment in primary position is of great concern in young patients because of cosmetic reasons. The globe can be fixed to the orbital wall with a non absorbable suture material. This results in restoration of binocular single vision and well aligned eyes in primary position with loss of horizontal gaze in involved eye. The procedure is easy, safe and effective. Al Shifa Journal of Ophthalmology 2005; 1(2): 60-63 © Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan.

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