Myopia is the most prevalent refractive error in the world and its incidence is increasing. Together with conservative methods of treatment, various surgical methods have been proposed. Corneal refractive surgery is probably the most accepted one. Laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and small incision lenticule extraction (SMILE) are suitable for treatment of myopia up to −8.00 D in the younger age group. For patients not suitable for corneal refractive surgery, lens-based procedures are available. Phakic intraocular lenses are suitable for patients younger than 45 years of age with high myopia or some other contraindications for corneal refractive surgery. For older patients, refractive lens exchange (RLE) with implantation of multifocal or monofocal intraocular lenses is gaining popularity.
Part of the book: Intraocular Lens
Paralytic strabismus is caused by paresis or paralysis of one or more extraocular muscles that are innervated by cranial nerve lll, IV and Vl. They are characterized by squinting angle that depends on the direction of the gaze and the fixating eye. Typically, the angle is greater in the field of affected muscle, and when the patient is fixing with the affected eye. While younger children in some cases can suppress double vision, older children and adults with acquired paralytic strabismus usually have diplopia, which they try to avoid by compensatory head posture. Some types of paralytic strabismus can be congenital but it is important to diagnose acquired paralytic strabismus that can be caused by some neurological or systemic disorders and requires further investigation. Treatment of the paralytic strabismus is challenging, and despite the multiple surgeries, results can be disappointing.
Part of the book: Treatment of Eye Motility Disorders