Importance of Photographic Evaluation in Oblique Muscle Surgery

Clinical Image: Ocular torsion is measured by various techniques like slit lamp biomicroscopy, indirect ophthalmoscopy, fundus photography and infrared imaging. On fundus photography, the torsional position of the eye is considered normal if a horizontal line drawn through the center of fovea passes within the inferior third of the disc. Fundus extorsion occurs in V pattern strabismus, dissociated vertical deviation, superior oblique palsy and primary inferior oblique over action. If inferior oblique muscle over action causes extorsion, recession is performed. Documenting preoperative torsion by fundus photography aids in analyzing the postoperative alignment and helps in explaining the results of surgery to the patient (Figure 1).