Ocular Motility Improvement In Crouzon Syndrome After Neurosurgical Intervention Without Strabismic Operation

We report a case with craniosynostosis showing spontaneous improvement in presumed superior oblique palsy and V pattern exotropia in long term follow-up. 3 year old girl presented with head-face anomaly, V patern exotropia and abnormal head posture admitted to our clinic. With the diagnosis of Crouzon syndrome bilateral coronal suture excision and decompression was made by neurosurgeons. After cranial operation the patient was followed up for 6 years without further cranial or strabismic operation. At the end of this period, we observed that corrected visual acuity was 20/20 in both eyes and her ocular deviation disappeared in all gaze positions. Strabismus in craniosynostosis may be related to anatomical malposition of the rectus muscles. Spontaneous improvement in ocular deviation may occur therefore this possibility must be considered in the planning of surgical intervention.