The main feature leading paralyticstrabismus caused by dysfunction of one or more extraocular muscles is limited or no eye movement in the direction of action of the affected muscle. This distinguishes it from concomitant strabismus.
A peculiar symptom of paralytic gosoglaziyaIt can be stimulated unusual position of the head. This can to some extent replace the rotations of the eyeballs. The patient turns his head in the direction of the affected muscles and thus often get rid of the painful ghosting.
If any of the functions of the vertical action of the muscleschildren receive so-called ocular torticollis: child bows her head to get rid of ghosting. With this torticollis sternocleidomastoid muscle (muscle Turn and tilt head, two of them - the right and left) is not changed and the child can keep your head properly.
True torticollis (involuntary head tilt inside in conjunction with the rotation of the head to the opposite side of the slope because of damage to the neck muscles on one side) does not depend on the state of the eyes, and the inclination of the head when it is due to stiffness, limited mobility sternocleidomastoid muscle. There is a double vision, dizziness. As a result, the deviation koyaschego eye from its normal position, as in concomitant strabismus, there is a disorder of binocular vision (when creating an image - the image involves two eyes).
However, it should be noted that in childrendiagnosis of paralytic strabismus is very difficult. Paralytic strabismus friendly unlike in children and adults is relatively rare (a few hundredths of a percent of the total incidence of organ of vision).
Paralytic strabismus may be dueor lesion of the relevant nerve dysfunction and morphology muscles themselves. Paralysis can be central and peripheral. The first are due to volume, inflammatory, vascular or degenerative changes and brain injuries, and the second - in the presence of similar processes and injuries of the orbit and the branches of the nerve itself. Changes in the muscles and nerves may be congenital in nature or occur as a result of infectious diseases (diphtheria), poisoning (botulism), abscesses (common abscess) of the orbit and is often a result of direct injury (torn muscle itself). Congenital paralysis are rare and are usually combined (struck several eye muscles).
With simultaneous paralysis of eye nerves comes complete ophthalmoplegia, which is characterized by the immobility of the eyes, ptosis (drooping of the upper eyelid) and pupil dilation.
Treatment of paralytic strabismus is primarilyOnly the elimination of the underlying disease, the result of which it was (infections, tumors, trauma, etc.). If as a result of the measures taken paralytic strabismus does not disappear, the question may arise about the surgical intervention.
Indications and operation time may be determinedonly in conjunction with the appropriate specialists (neurologist, oncologist, infectious diseases, and others.). Posttraumatic strabismus usually surgically corrected after at least six months from the time of injury, since in this case the possible regeneration (restoration) of the muscles and nerves, and consequently the partial and complete recovery of their functions.