The AAO Journal, 2023/06, 33(2):24-25. doi: 10.53702/2375-5717-33.2.20, type of study: ,cr,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Free full text   (https://meridian.allenpress.com/aaoj/article/33/2/20/493544/LBORC-NUFA-Poster-Abstracts-2023-Students)

Keywords:

adolescent [83]
case report [736]
esotropia [2]
OMT [3925]
osteopathic manipulative treatment [3946]
pediatrics [573]
strabismus [5]

Abstract:

Introduction/Background: Strabismus is insufficiency of the EOMs by mechanical or neurological causes, resulting in misalignment of the visual axes. It is thought that strain patterns affecting the bony orbit and compromising these muscles’ attachments and insertion points can be targeted using osteopathic manipulative treatment (OMT). Here we discuss a patient who presented with esotropia and was successfully treated using prism lenses and OMT. Case: A 14-year-old presented to clinic with new complaints of headache and visual disturbance. Physical exam revealed esotropia of the right eye, left unilateral sacral flexion, left lateral strain with spheno-basilar-synchondrosis (SBS) restriction favoring flexion phase, occipitomastoid suture restriction bilaterally, and temporal bone dysfunction. Head was normocephalic and atraumatic. The patient was treated in clinic using cranial technique, myofascial release, balanced ligamentous tension, muscle energy, and Still technique. Significant improvement in somatic dysfunction and esotropia was noted by physician and the patient immediately posttreatment, and the patient was advised to follow up with optometrist. Results: At their follow up visit, the patient noted resolution of the headache and visual disturbance. On cranial examination, there was an absence of the original left lateral strain pattern, SBS restriction, and occipitomastoid suture restriction. No optometric exam was preformed other than Snellen eye chart and gross visual examination. The patient was able to obtain prism lenses through their optometrist, which were used only as needed with regular OMT. Discussion: It is theorized that the left lateral strain and downward pull of the reciprocal tension membrane contributed to the visual disturbances and, to a degree, the patient’s esotropia. Based on this theory, it is possible that regular OMT can help alleviate the long-term need for prism lenses in patients with strabismus.