Strabismus with DVD in a 12 year old.

摘要

Twelve-year-old Sarah and her mother report that the drifting of Sarah's left eye has become much worse in the past 3 months. Sarah says her friends constantly remind her to stop daydreaming and pay attention. Her mother notes Sarah's left eyelids close almost automatically when she is outdoors.You operated on Sarah at age 10 months for a 45 prism diopter (PD) esotropia with bimedial rectus recessions. At the time, there was slight bilateral inferior oblique overaction. However, a true V-pattern was not detected.After regular follow-up examinations and appropriate amblyopia treatment, Sarah's best visual acuity at age 10 years was 20/20 in the right eye and 20/25 in the left eye. There was a 3 to 5 PD left esotropia. At that examination, her mother reported and you also noted an occasional dissociated vertical divergence (DVD) that primarily involved the left eye.