Neuro-Ophthalmic Considerations in Pediatric Orbital and Oculoplastic Disease

Abstract

The pediatric oculoplastic surgeon frequently cares for patients whose clinical manifestations mimic or represent a neuro-ophthalmic condition. A familiarity with neuro-ophthalmic entities commonly seen by the oculoplastic subspecialist is critical, as proper recognition is essential to ensuring timely diagnosis, treatment, and, sometimes, the avoidance of unnecessary surgery. Myasthenia gravis, congenital myasthenic syndromes, Horner syndrome, third nerve palsy, optic nerve glioma, cavernous sinus thrombosis, myotonic muscular dystrophy, chronic progressive external ophthalmoplegia, Kearns-Sayre syndrome, and congenital fibrosis of the extraocular muscles are diseases covered in this chapter. Although some of these conditions are covered elsewhere in this textbook, this chapter focuses on the neuro-ophthalmic features and implications which are relevant for the oculoplastic surgeon.