American Family Vision Clinic Logo
Authors
Kim, Jae Hyoung; Hwang, Jeong-Min

Variable Synergistic Divergence

publication date
July 25, 2009
Category
see more

Abstract/Introduction

Purpose. 

To report a patient with congenital fibrosis of the extraocular muscles showing either synergistic divergence or adduction.

 

Case Report

A 7-year-old girl presented with complaints of abnormal eye movement since early childhood. A detailed ophthalmologic examination was performed. On ophthalmologic evaluation, her corrected visual acuities were 20/50 OU. She had 12 prism diopters of exotropia at distance and near in the primary position. During attempted right gaze, OU abducted. During attempted left gaze, the right eye adducted or abducted. Upgaze and downgaze were limited. Levator function was evaluated at 0 mm with a marginal reflex distance of −1 in OU. On thin-section brain stem magnetic resonance imaging, the left abducens nerve was absent, and the right and left oculomotor nerves were severely hypoplastic. The oculomotor nerve was smaller than the acoustic nerve was, and this was interpreted as hypoplasia according to a previous method (Kim and Hwang, Ophthalmology 2005;112:728–32). The medial and superior recti of OU were atrophic.


Conclusion/Results

Conclusions. 

A patient with congenital fibrosis of the extraocular muscles may show alternatively either synergistic divergence or adduction, which has not been documented before.


Testimonials


  • Such a nice optician. My grandson is only 4 and needs glasses. We were so sad, but he explained the issues, and we will follow up as he suggested.


    Anna P.

  • I had such a good experience with the clinic. Very friendly staff and doctor, did not have to wait for long to be called, and was treated respectfully. Thanks, American Family.


    June S.

  • Dr. Zurcher has gone above and beyond what any other eye doctor has ever done to figure out what is going on with my eyes. Very happy with American Family Vision.


    Christine R.

  • Family Vision Clinic changed our lives! My daughter was frequently car sick, and she was getting headaches every day, often painful enough that they brought her to tears. We saw a string of doctors and therapists, but we made no progress. Finally, we found Dr. Levi Zurcher and his eye therapist Rain. After ten weeks of eye therapy my daughter no longer gets headaches, and she no longer gets car sick. Daily tears are a thing of the past. I really can’t say enough about this clinic. It was fascinating to watch Dr. Zurcher work. For the first time, someone who knew what they were doing was intently studying my daughter, really trying to figure out all of her eye issues, and his therapist Rain is one of the most patient and lovely people that I’ve ever had the good fortune to meet. We’re finished with eye therapy—yay!—and I have switched to American Family Vision Clinic for all of my family’s other eye health needs.


    Lars Wulff

  • Very professional, yet kind and helpful. They do what they can to make the appointment comfortable. I was running a bit late, I made sure ti call. They were able to switch me with a patient who was already there, they treated me with respect, and helped my son have confidence by getting him the eye care he needed that day. Thank you so much! Would recommend to anyone. It's a blessing that they care enough to work with people who have all different types of insurance from work to state coverage.


    Justin E.

Blog

kevin-lehtla-X1PDHkKuvwc-unsplash

Sunglasses and UV protection for your eyes

According to a new nationwide survey released, three-quarters of Americans worry about potential eye problems caused by the sun's ultraviolet […]

Read More
jack-b-oWUeGozstgs-unsplash

Scratched eye

The purpose of this article is to explain how to deal with corneal abrasions. If you scratched your eye you […]

Read More
Atkinson Hyperlegible Font (1)

Atkinson Hyperlegible Font

Named after Braille Institute founder, J. Robert Atkinson, Atkinson Hyperlegible font is great for low vision readers.  In contrast to […]

Read More
see all blogs

Contact Us To Amplify Your EyeCare

Working Hours

Monday - Thursday
8:00 am - 5:15pm
friday-sunday
Closed
Location
400 Yauger Way SW. Bldg 1, Ste A Olympia, WA 98502
Website Accessibility Policy
Safety protocols page
phone-handsetarrow-uparrow-right linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram