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, Southern Medical Association, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

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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