Abstract

A seven year old child presented with abnormal eye movements after craniotomy for posterior fossa tumour excision and VP shunt 8 months back. After the surgery the mother noticed inward deviation of both when the child looks in lateral gazes
On examintion the best corrected visual acuity of the child is 6/6 in both eyes. There was abduction deficit of -3 on right abduction and -2 on left abduction associated with synergistic convergence on lateral gazes. the prism bar cover test showed 35 prism dioptres of esotropia in primary gaze and 45 prism dioptres in right gaze and 40 prism dioptres in left gaze.
The child was operated with modified nishida's on superior and inferior rectus muscles bilaterally and post operative 1 month showed 9 prism dioptres of residual esotropia with abduction of -1 in right gaze and -1/2 in left gaze

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