V-Pattern Esotropia and Exotropia Differential Diagnoses

1. Duane A. Isolated paralysis of the ocular muscles. Arch Ophthalmol. 1897. 26:317.

2. Costenbader FD. Introduction Symposium: The A and V patterns in strabismus. Trans Am Acad Ophthalmol Otolaryngol. 1964. 58:354.

3. Mohan K, Saroha V. Cyclic "V" esotropia. J Pediatr Ophthalmol Strabismus. 2004 Mar-Apr. 41(2):122-5. [Medline].

4. Pott JW, Godts D, Kerkhof DB, de Faber JT. Cyclic esotropia and the treatment of over-elevation in adduction and V-pattern. Br J Ophthalmol. 2004 Jan. 88(1):66-8. [Medline].

5. Caldeira JA. Some clinical characteristics of V-pattern exotropia and surgical outcome after bilateral recession of the inferior oblique muscle: a retrospective study of 22 consecutive patients and a comparison with V-pattern esotropia. Binocul Vis Strabismus Q. 2004. 19(3):139-50. [Medline].

6. Caldeira JA. V-pattern esotropia: a review; and a study of the outcome after bilateral recession of the inferior oblique muscle: a retrospective study of 78 consecutive patients. Binocul Vis Strabismus Q. 2003. 18(1):35-48; discussion 49-50. [Medline].

7. Monteiro de Carvalho KM, Minguini N, Dantas FJ, et al. Quantification (grading) of inferior oblique muscle recession for V-pattern strabismus. Binocul Vis Strabismus Q. 1998. 13(3):181-4. [Medline].

8. Minguini N, de Carvalho KM, de Araujo L, Crosta C. Anterior transposition compared to graded recession of the inferior oblique muscle for V-pattern strabismus. Strabismus. 2004 Dec. 12(4):221-5. [Medline].

9. Lee SY, Cho HK, Kim HK, Lee YC. The effect of inferior oblique muscle z myotomy in patients with inferior oblique overaction. J Pediatr Ophthalmol Strabismus. 2010 Nov 1. 47(6):366-72. [Medline].

10. Knapp P. Vertically incomitant horizontal strabismus, the so called A and V syndromes. Trans Am Ophthalmol Soc. 1959. 57:666.

11. Oya Y, Yagasaki T, Maeda M, Tsukui M, Ichikawa K. Effects of vertical offsets of the horizontal rectus muscles in V-pattern exotropia without oblique dysfunction. J AAPOS. 2009 Dec. 13(6):575-7. [Medline].

12. Ohba M, Ohtsuka K, Osanai H. Treatment for A and V strabismus by slanting muscle insertions. Binocul Vis Strabismus Q. 2004. 19(1):13-20. [Medline].

13. Mostafa AM, Kassem RR. A comparative study of medial rectus slanting recession versus recession with downward transposition for correction of V-pattern esotropia. J AAPOS. 2010 Apr. 14(2):127-31. [Medline].

14. Goldstein JH. Monocular values for the A and V syndromes. Am J Ophthalmol. 1960. 50:753.

15. Pineles SL, Rosenbaum AL, Demer JL. Decreased postoperative drift in intermittent exotropia associated with A and V patterns. J AAPOS. 2009 Apr. 13(2):127-31. [Medline]. [Full Text].

16. Bieder B, Yassur Y. Treatment for A or V patterns by slanting the muscle insertion. Lennerstrand G, ed. Update on Strabismus and Pediatric Ophthalmology. CRC Press; 1995. 260.

17. Boyd TA, Leitch GT, Budd GE. A new treatment for 'A' and 'V' patterns in strabismus by slanting muscle insertions. A preliminary report. Can J Ophthalmol. 1971 Jul. 6(3):170-7. [Medline].

18. Brown HW. Vertical deviations symposium: Strabismus. Trans Am Acad Ophthalmol Otolaryngol. 1953. 57:157.

19. Clark RA, Miller JM, Rosenbaum AL, Demer JL. Heterotopic muscle pulleys or oblique muscle dysfunction?. J AAPOS. 1998 Feb. 2(1):17-25. [Medline].

20. Fink WH. The A and V syndromes. Am Orthopt J. 1959. 9:105.

21. Gobin MH. Sagittalization of the oblique muscles as a possible cause for the "A", "V", and "X" phenomena. Br J Ophthalmol. 1968 Jan. 52(1):13-8. [Medline].

22. Helveston EM. A logical scheme for planning of strabismus surgery. Surgical Management of Strabismus. An Atlas of Strabismus Surgery. CV Mosby; 1993. 381.

23. Jampolsky A. Oblique muscle surgery of the A-V patterns. J Pediatr Ophthalmol. 1965. 2:31.

24. Knapp P. A and V patterns. Transections of the New Orleans Academy Of Ophthalmology. Mosby-Year Book; 1971. 242.

25. Kushner BJ. The role of ocular torsion on the etiology of A and V patterns. J Pediatr Ophthalmol Strabismus. 1985 Sep-Oct. 22(5):171-9. [Medline].

26. Miller JE. Vertical recti transplantation in the A and V syndromes. Arch Ophthalmol. 1960. 64:175.

27. Miller M, Folk E. Strabismus associated with craniofacial anomalies. Am Orthopt J. 1975. 25:27-37. [Medline].

28. Ohba M, Nakagawa T. Treatment for "A" and "V" exotropia by slanting muscle insertions. Jpn J Ophthalmol. 2000 Jul-Aug. 44(4):433-8. [Medline].

29. Parks MM, Mitchell PR. A and V patterns. Tasman W, Jaeger EA, eds. Duane’s Clinical Ophthalmology. Philadelphia: Lippincott-Raven; 1996. Vol 1:

30. Polati M, Gomi C. Recession and measured, graded anterior transposition of the inferior oblique muscles for V-pattern strabismus: outcome of 44 procedures in 22 typical patients. Binocul Vis Strabismus Q. 2002. 17(2):89-94. [Medline].

31. Saunders RA, Holgate RC. Rectus muscle position in V-pattern strabismus. A study with coronal computed tomography scanning. Graefes Arch Clin Exp Ophthalmol. 1988. 226(2):183-6. [Medline].

32. Scott WE, Drummond GT, Keech RV. Vertical offsets of horizontal recti muscles in the management of A and V pattern strabismus. Aust N Z J Ophthalmol. 1989 Aug. 17(3):281-8. [Medline].

33. Stager DR, Parks MM. Inferior oblique weakening procedures. Effect on primary position horizontal alignment. Arch Ophthalmol. 1973 Jul. 90(1):15-6. [Medline].

34. Urist MJ. The etiology of the so called A and V syndromes. Am J Ophthalmol. 1958. 46:835.

35. Von Noorden GK. A and V patterns. Binocular Vision and Ocular Motility: Theory and Management of Strabismus. 5th ed. St. Louis: Mosby; 1996. 376.

36. Wilson J, Spika J, Clarke R, et al. Verocytotoxigenic Escherichia coli infection in dairy farm families. Can Commun Dis Rep. 1998 Feb 1. 24(3):17-20. [Medline].

Neepa Thacker, MBBS, MS, DNB, FRCS Consulting Staff, Department of Pediatric Ophthalmology and Strabismus, Breach Candy Hospital; Head, Department of Pediatric Ophthalmology and Strabismus, Lotus Eye Hospital, India

Disclosure: Nothing to disclose.

Arthur L Rosenbaum, MD 

Arthur L Rosenbaum, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Medical Association

Disclosure: Nothing to disclose.

Federico G Velez, MD Assistant Clinical Professor, Department of Ophthalmology, Division of Pediatric Ophthalmology and Strabismus, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Federico G Velez, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

J James Rowsey, MD Former Director of Corneal Services, St Luke's Cataract and Laser Institute

J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Sigma Xi, The Scientific Research Honor Society, Southern Medical Association, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Donny W Suh, MD, FAAP Chief of Pediatric Ophthalmology and Strabismus, Children's Hospital and Medical Center; Associate Professor, Department of Ophthalmology and Visual Sciences, Truhlsen Eye Institute, University of Nebraska Medical Center

Donny W Suh, MD, FAAP is a member of the following medical societies: American Academy of Ophthalmology, American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus, American Medical Association, Iowa Medical Society, National Eye Care Project

Disclosure: Nothing to disclose.

Michael J Bartiss, OD, MD Medical Director, Ophthalmology, Family Eye Care of the Carolinas and Surgery Center of Pinehurst

Michael J Bartiss, OD, MD is a member of the following medical societies: American Academy of Ophthalmology, North Carolina Medical Society, American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus

Disclosure: Nothing to disclose.

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