title: Treatment of congenital adduction palsy with synergistic divergence.
abstract: OBJECTIVE
  To report on successful management of congenital adduction palsy with synergistic divergence by performing weakening surgery on the superior and inferior oblique muscles.
  
  
  METHODS
  We performed a total tenotomy of the lateral rectus muscle, followed by resection of the medial rectus muscle and tenotomy of the superior oblique and myectomy of the inferior oblique muscles in a patient who had congenital adduction palsy with synergistic divergence.
  
  
  RESULTS
  Total tenotomy of the lateral rectus muscle had no effect on synergistic divergence, resection of the medial rectus muscle reduced it to some extent and tenotomy of the superior oblique and myectomy of the inferior oblique muscles further reduced this phenomenon. The improvement in synergistic divergence was maintained at 2 1/2 years later at follow up.
  
  
  CONCLUSIONS
  Weakening surgery on the superior and inferior oblique muscles should be considered in the management of synergistic divergence.
authors.affiliation: Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: K
authors.initials: K
authors.lastname: Mohan
authors.forename: R
authors.initials: R
authors.lastname: Gupta
authors.forename: A
authors.initials: A
authors.lastname: Sharma
authors.forename: A
authors.initials: A
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D005099:Exotropia / Q000601:surgery*; D005133:Eye Movements; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000294:innervation / Q000601:surgery*; D009886:Ophthalmoplegia / Q000151:congenital* / Q000601:surgery*; D012086:Reoperation; D014792:Visual Acuity