Chapter-19.10 Myogenic Strabismus

BOOK TITLE: Postgraduate Ophthalmology (2 Volumes)

1. Chaudhuri Zia
2. Agarkar Sumita
3. Pandey Pramod K
Publishing Year
Author Affiliations
1. Guru Nanak Eye Center, New Delhi, India, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India, Maulana Azad Medical College, New Delhi, Maulana Azad Medical College and Associated Hospitals, Guru Nanak Eye Center, New Delhi, India
2. Sankara Nethralaya, Chennai, Tamil Nadu, India, Sankara Nethralaya A Unit of Medical Research Foundation, Nungambakkam, Chennai, Tamil Nadu, India
3. Guru Nanak Eye Center, Maulana Azad Medical College and Associated Hospitals, New Delhi, India
Chapter keywords
myogenic forms of strabismus, EOM, ocular motility abnormalities, regular cardiac evaluation, conduction defects, neurological assessment, acquired myasthenia gravis (MG), autoimmune disorder, acetylcholine receptors, MRI or CT, mediastinum (thin sections), thymoma, diplopia, monocular occlusion, strabismus surgery


Myogenic forms of strabismus comprise a group where the EOM is the primarily affected entity that results in ocular motility abnormalities. Chronic progressive external ophthalmoplegia (CPEO) is a disorder resulting in progressive loss of ocular movements and bilateral ptosis along with other ocular and systemic findings. Regular cardiac evaluation for conduction defects and neurological assessment is required. Acquired myasthenia gravis (MG) is an autoimmune disorder characterized by clinical fatigue and pathologic loss of acetylcholine receptors at the postsynaptic portion of the neuromuscular junction. MRI or CT of the mediastinum (thin sections) is indicated to rule out a thymoma or thymic enlargement. Diplopia may be treated by monocular occlusion initially, or by Fresnel prisms. Strabismus surgery may be considered if the patients have shown stable misalignment for over a year.

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