Question

My daughter had five surgeries prior to the age of two for stabismus. They were all performed by a pediatric opthomologist, Richard Elliot. When he wanted to do surgery #6, we balked. My daughter is now 21 and the left eye follows an A pattern and moves to the left, most noticably when she is tired. She has developed some coping strategies to deal with her self-consciousness of the eye. The opthomologist we see on a regular basis said he is not the man to perform the surgery. He said she deserves to have it done by someone who an expert in the field and not disappoint us. The doctor who performed the first 5 surgeries was supposed to be an expert! Where do we go for help?

Thank you.

(Marilyn)

Answer:

Dear Marilyn,

A-patteren motility (eyes converging=moving-towards-nose when looking up and diverging=eyes-moving-outward when looking down) is one of the most difficult conditions to treat. Many patients with A-pattern motility have complaints. It 's so unnatural: Normal people read in downgaze and therefore converge in downgaze, and this is just the opposite ! If any surgery is contemplated, the first thing to do is to get rid of the A-pattern as much as possible. If you live in Anaheim, please contact Professor Joe Demer (Jules Stein Eye Institute, 100 Stein Plaza, UCLA, LA, CA90024-7002) for an exam and advice. He may refer you to someone else though, for this specific problem.

Yours truly,

(Herb Simonsz, MD, PhD)

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