Heavy eye syndrome in a paediatric patient: an unusual presentation of highly myopic restrictive strabismus.
Giuseppe Rao, Simone Cuccurnia, Alice Laviosa et al.
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Case in brief
A teenage girl presented with progressive myopia and large-angle esotropia, diagnosed with heavy eye syndrome, typically seen in adults. Coronal orbital MRI revealed inferior slippage of the lateral recti and nasal slippage of the superior recti. A two-stage surgical approach, including a bilateral Yokoyama procedure and bilateral medial rectus recession, successfully corrected her ocular alignment and improved motility.
Diagnostic / clinical pearl
Heavy eye syndrome can occur in pediatric patients, presenting with significant strabismus and requiring careful imaging for diagnosis.
Why it matters
Recognizing heavy eye syndrome in younger patients can lead to appropriate surgical management, improving outcomes in cases of progressive myopia.