Purpose: To determine the importance of oblique muscle dysfunctions in the etiopathogeny of alphabetic syndromes ("A" and "V"); to determine which oblique dysfunction is more often associated with each alphabetic syndrome. Methods: 178 patients with eso/exodeviations and alphabetic syndromes ("A" or "V"), with or without oblique muscle dysfunctions, were retrospectivelly studied. Patients with special forms of strabismus (syndromes and paresis) and patients with previous strabismus surgery were excluded from the study. Results: 78 patients with "A" pattern were studied: 44 women and 34 men; 61 patients were 20 years old or younger and 17 patients were older; 59 eso- and 19 exodeviations; 58 patients with an "A" pattern of 30 prismatic diopters or smaller, 12 patients with "A" pattern diagnosed by the corneal reflex only and 8 patients with the variation greater than 30; oblique muscle dysfunctions were observed in 70 of the 78 patients studied (bilateral superior oblique overaction associated with bilateral inferior oblique underaction (31 cases) and isolated bilateral superior oblique overaction (12 cases) were more frequently found.One hundred patients with "V" pattern were studied: 58 women and 42 men; 77 patients were 10 years old or younger; 65 eso- and 34 exodeviations and 1 orthotropia; 71 patients with "V" ranging from 10 to 30 prismatic diopters; oblique muscle dysfunctions were found in 93 patients and isolated bilateral inferior oblique overaction (33 cases) and bilateral inferior oblique muscle overaction associated with bilateral superior oblique muscle underaction (30 cases) were more frequently observed. Conclusions: The results of this study confirm the importance of oblique muscle dysfunctions in the etiopathogeny of alphabetic syndromes.
Oculomotor muscles; Anisotropy; Strabismus
