title: Vertical and cyclotorsional deviations following peribulbar anesthesia.
abstract: BACKGROUND
  Motility disorders may occur consecutive to peribulbar anesthesia. The underlying pathology is still debated. The aim of the study was to contribute to the discussion by a meticulous orthoptic examination of a series of patients.
  
  
  METHODS
  In a series of 16 patients with diplopia after peribulbar anesthesia, measurements of the angle of squint in the nine directions of gaze, Bielschowsky's headtilt test and motility analysis were performed. The findings were discussed with regard to the possible types of muscular lesions.
  
  
  RESULTS
  Hypotropia and deorsoadduction accompanied by relatively small cyclotropia were found in all cases. Bielschowsky's head-tilt test mostly revealed neutral findings.
  
  
  CONCLUSIONS
  The findings were discussed under the hypothesis of a fibrotic muscular change in the superior oblique and inferior rectus muscle. This hypothesis turned out to be concordant with the orthoptic measurements, implying that treatment of the disorder should consist in low-dosage recession of the fibrotic muscles, which in our experience was rewarding.
authors.affiliation: Zentrum für Augenheilkunde der Univesität zu Köln, Cologne, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Neugebauer
authors.forename: J
authors.initials: J
authors.lastname: Fricke
authors.forename: U
authors.initials: U
authors.lastname: Pink
authors.forename: W
authors.initials: W
authors.lastname: Rüssmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage; D004172:Diplopia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005133:Eye Movements; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D009801:Oculomotor Muscles / Q000503:physiopathology; D009915:Orbit; D018918:Phacoemulsification; D012307:Risk Factors
chemical_list: D000779:Anesthetics, Local