Dr. REENA GUPTA

Dr. NEEBHA ANAND, Dr. CHEKITAAN SINGH, Dr. CHAWLA URMIL

Abstract

Managing vertical strabismus with large angle horizontal deviation has always been a challenge. We report a case successfully treated by Modified Knapp’s Procedure.15 year old girl with moderate ptosis and limitation in elevation, adduction in the left eye with exotropia and hypotropia, diagnosed as a case of partial recovered 3rd nerve palsy. Orthoptic evaluation revealed exotropia 55 BI with 20 R/L in the primary gaze increasing on dextroversion. Forced duction test was planned to decide further management. FDT was not tight and the patient was operated by Modified Knapp’s procedure in which LR muscle was recessed 8 mm and MR resected 6 mm and both transposed to SR. On follow up patient was able to achieve optimal alignment and mild improvement in elevation. The long term success of stable alignment advocates modified KNAPP’S as a convenient single stage procedure to correct horizontal deviation with vertical strabismus in paralytic cases and improve ocular motility.