Avtor/Urednik		Kurent, Alma; Kosec, Dragica
Naslov		Surgical treatment of a patient with congenital nystagmus with compensatory head posture
Prevedeni naslov		Kirurško zdravljenje bolnice s prirojenim nistagmusom s kompenzatorno držo glave - prikaz primera
Tip		članek
Vol. in št.		Letnik 89, št. 9/10
Leto izdaje		2020
Obseg		str. 515-520
ISSN		1318-0347 - Zdravniški vestnik : glasilo Slovenskega zdravniškega društva : Slovenian medical journal
Jezik		eng
Abstrakt		The correction of compensatory head posture in a congenital nystagmus involves surgical treat - ment that includes recession and resection of extraocular muscles to move the eccentric null zone to a primary position. A 39-year-old patient presented with an impaired visual acuity and nystagmus that was present since childhood. She had a left head turn with permanent neck pain. At the examination, best corrected visual acuity was 0.4 in both eyes with her glasses. Correction in the right eye was -6.50-1.50/180° and in the left eye -5.50-2.50/180°. Measured objective and subjective angles of squint were +4°, fusion from -3° to +29°, with the presence of stereo vision. During the cover test the nystagmus was present and it enhanced while covering the eye. Ocular motility was not lim- ited. Fundus examination revealed myopic changes in both eyes. Prisms were prescribed, which were well tolerated by the patient. Also, no apparent head turn was noticed while wearing the prisms. Nine months later, the patient underwent a Kestenbaum procedure. Retroposition of the lateral rectus muscle with resection of the medial rectus muscle in the right eye and retroposition of the medial rectus muscle with resection of the lateral rectus muscle in the left eye were performed. After the procedure nystagmus dampened the most in the minimal left position, the head was in a straight position. Two years after the procedure nystagmus dampened the most in the primary position, the head was in a straight position. Nine years after surgery and refractive correction with contact lenses, the visual acuity was 0.8-0.9p in both eyes. The presented case showed that adequate functional and surgical treatment led to a good mor - phological outcome with improved visual acuity in a patient with congenital nystagmus and a compensatory head posture even in adulthood.
Proste vsebinske oznake		nistagmus nična točka kompenzatorna drža glave nystagmus null zone compensatory head posture