DR.ANNU JOON

DR. PRIYA SARAF, DR.NIKHIL GOTMARE, DR.SHWETA VISWANATH

Abstract

We report a rare case of slipped medial rectus (MR) muscle in right eye of 11yo girl post trauma with bicycle handle.History of surgical intervention at 1week elsewhere-lacerated MR reattachment at 5.5mm from limbus. 1year post trauma/surgery,on presentation, there was 90pd exotropia,-3 adduction,diplopia in all gazes (maximum separation in levoversion).FDT for LR normal and FGT for MR displayed fair function.Orbital imaging confirmed muscle in posterior sheath.Diagnosis of slipped MR made.MR exploration done under GA,slipped muscle found in posterior sheath, confirmed by oculocardiac reflex. Capsule was dissected, scar tissue excised, muscle secured with sutures, reattached with advancement. Postoperatively, patient was orthotropic, full ocular motility (adduction),no diplopia.

Conclusion-MR disinsertion post trauma/surgery is a rare complication.Clinical evaluation and imaging aid in diagnosis.Meticulous surgical exploration and reattachment of muscle yield satisfactory results