Abstract

STUDY DESIGN
Prospective Interventional study
PURPOSE
To report the surgical outcome of 4 rare cases of Helveston Syndrome-the triad exotropia of ‘Dissociated vertical deviation,Superior oblique(SO) overaction,and A-pattern exotropia
METHODS
Current management include superior rectus(SR) recession alone or combined with posterior tenectomy of SO. However there cannot be a singular dictum of management as one key does not fit all locks.
Therefore, depending on the magnitude of the deviation, the cases were managed with a permutation and combination of surgeries-lateral rectus recession with it’s half width infra placement,medial rectus resection, posterior tenectomy of SO, Faden’s operation of SR and muscle transplantation procedures.
The patients were on regular follow up.
RESULTS
In all cases, optimum correction is seen in all 3 components of the syndrome
CONCLUSION
Optimum outcome acceptable to the patients is seen when surgery is tailored to the patient's magnitude of deviation.