Studies on anatorrtical abnormality of extra ocular muscles and binocularity.

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We examined the patients clinically diagnosed as congenital superior oblique palsy with magnetic resonance imaging. Patients who had atrophic superior oblique muscle showed larger horizontal and vertical deviation than patients with normal volume of superior oblique muscle. The patients who had atrophic superior oblique muscle required more muscles to be operated than the patients with normal volume superior oblique muscle. We proposed a new surgical algorithm, and we showed the effectiveness of the algorithm. The eyes with atrophic superior oblique muscles had higher risk of astigmatism and treatment of amblyopia was more often required. Forced traction testing of superior oblique tendon correlated with imaging study.We studied the relationship between superior oblique muscle atrophy and facial asymmetry utilizing cephalometric x-ray. There was no relationship between bony anomaly of face and the volume of superior oblique muscle. The facial asymmetry does not seem to be the cause of superior oblique muscle atrophy but the result.We examined the eye movement on the patients with third nerve palsy, and who underwent excision of the lateral rectus muscle. After the surgery, the eye still moved laterally, which suggested the existence of connective tissue between the eye ball and extra ocular muscle.We performed contralateral rotation of eye after macular translocation surgery with 3 60-degree retinotomy. The eye was rotated 10-35 degrees, but the position of extra ocular muscles in orbit did not change. This finding suggests, that extra ocular muscles are strongly connected to the orbit by pulley structure.