Burton J Kushner

PURPOSE: Inferior oblique anteriorization is gaining popularity for the treatment of dissociated vertical divergence associated with inferior oblique overaction. This procedure is based on the theory that moving the insertion of the inferior oblique muscle anterior to the equator changes its vector of force from one of elevation to one that opposes elevation. The purpose of this investigation is to describe, investigate the cause, and outline treatment for a complication I observed after ...

OBJECTIVE: To determine if there is better long-term motor alignment or sensory outcome 5 years after surgery for infantile esotropia for patients who exhibit any of three categories of alignment 6 months after surgery: orthotropia, up to 8 prism diopters (delta) of esotropia, or up to 8 delta of exotropia.

DESIGN: A 15-year prospective study with 5-year outcome determination was conducted in surgically treated esotropic infants.

RESULTS: Of 118 patients in the study group, 24 had ...

PURPOSE: Success with nasolacrimal duct probing has been shown to be inversely correlated with age. Consequently, several authors have suggested that the older child with a previously untreated nasolacrimal duct obstruction should undergo silicone intubation or a balloon catheterization as the primary surgical procedure because older children are more likely to have complicated obstructions that will not respond to simple probing. The purpose of this study was to investigate the ...

Many adult patients with strabismus are under the misconception that nothing can be done to correct the problem or that treatment is associated with a high degree of risk. Moreover, many optometrists, comprehensive ophthalmologists and primary care physicians are similarly misinformed. In fact, most adult patients with strabismus can be successfully treated, with ∼80% of patients achieving satisfactory alignment with one surgical procedure. In addition, adult strabismus surgery carries a ...

BACKGROUND: Patients with exotropia often have a slow-to-dissipate fusional mechanism at near, which masks the true near deviation. Consequently, determination of the accommodation convergence-accommodation (AC/A) ratio in patients with exotropia must be based on near measurements obtained after prolonged monocular occlusion (typically 1 hour). When determined in that manner, the presence of a high AC/A ratio before surgery in an exotropic patient has been reported to be predictive of an ...

OBJECTIVE: To determine the usefulness of Teller Acuity Cards for detecting three levels of vision deficit, the cutoff for amblyopia (20/40 or poorer), vision impairment (20/70), or legal blindness (20/200).

DESIGN: We compared grating visual acuity with the Teller cards with Snellen visual acuity (our gold standard) in 69 literate patients with amblyopia or other cause of vision loss in a prospective masked study.

RESULTS: Teller card visual acuity and distance Snellen visual acuity ...

BACKGROUND: Burian's classification of exotropia based on the difference between the distance deviation and near deviation (distance/near differences) leaves some questions unanswered. Controversy exists concerning whether the divergence excess pattern is caused by an excess of divergence or by excessive accommodative convergence. Much of the literature on this subject has been confusing because investigators did not eliminate tenacious proximal fusion as an artifact in calculating the ...

BACKGROUND: Slipped muscles are complications of strabismus surgery that are encountered more frequently after recessions of the inferior and medial rectus muscles.

METHODS: We obtained multipositional high-resolution magnetic resonance imaging of 10 orbits of 6 normal subjects, 9 orbits of 5 patients with thyroid-associated eye disease, and 4 orbits of 2 patients with thyroid-associated eye disease on the day after rectus muscle recessions using a suspension technique. The arc of ...

OBJECTIVES: To determine how frequently adults with long-standing esotropia will experience an expansion of their binocular visual field after surgical correction of their strabismus and to determine if the postoperative expansion of binocular fields in esotropic adults correlates with the type of esotropia (infantile vs acquired), duration of the deviation, visual acuity in the deviating eye, or a history of satisfactory alignment in early childhood.

DESIGN: Preoperative and ...

BACKGROUND: The efficacy of treating anisometropic amblyopia with occlusion therapy is well known. However, this form of treatment can be associated with risks. Spectacle correction alone may be a successful and underutilized form of treatment.

METHODS: The records of 28 patients treated successfully for anisometropic amblyopia with glasses alone were reviewed. Age, initial visual acuity and stereoacuity, and nature of anisometropia were analyzed to assess associations with time required ...

Strabismus surgery in adults achieves satisfactory alignment with one operation in approximately 80% of patients, depending on the specific nature of the problem. Risks of adult strabismus surgery are relatively low, and serious complications are anecdotal and rare. Even if the strabismus has been long-standing, most adults will experience some improvement in binocular function after strabismus surgery. Consequently, adult strabismus surgery should not be considered merely cosmetic in ...