View abstract

Title

Eyemovement disorders associated with abnormal orbital growth

Purpose	To describe 15 years’ experience of eyemovement disorders associated with abnormal orbital growth secondary to craniosynostoses.
Methods	A retrospective review of casenotes, and literature review of studies from our own unit and those from other craniofacial units.
Results	Children with craniosynostoses, especially the syndromic variety, display upshoots in adduction and concomitant downshoots in abduction. Orbital imaging reveals excyclorotated rectus muscles in these cases. Surgical management of such cases is best managed with anteriorisation of the inferior oblique with ‘J’ deformity. Patients with syndromic craniosynostoses also may exhibit missing muscles. Utilisation of a ‘Foster suture’ in any transposition surgery greatly enhances the end effect of surgical intervention.
Conclusion	Children with abnormal orbital growth due to craniosynostoses exhibit peculiar eyemovement anomalies which need careful evaluation , orbital imaging and a surgical approach that expects anomalous and or missing muscles.

Author 1