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Strabismus Secondary to Adnexal Restrictions

Correspondence: Requests for reprints should be addressed to: Dr. Gregg Lueder, Dept. of Ophthalmology and Visual Sciences, Washington University Medical Center, Box 8096, 660 S. Euclid Ave., St. Louis, MO 63110 e-mail: lueder{at}vision.wustl.edu

Adnexal restriction due to anomalous orbital structures is a rare cause of strabismus. These anomalous structures include accessory muscles and fibrous bands that insert in abnormal locations on the globe or on the extraocular muscles themselves. They may be present in patients with restrictive strabismus with unusual patterns of motility, including globe retraction not associated with Duane retraction syndrome, very large vertical strabismus, and elevation deficits that are worse in abduction. Imaging studies are useful in the evaluation of such patients. Release of the restrictive orbital structures may improve the strabismus in some patients.

Key words: eye muscles, anomalous muscles