====== Surgery for A and V Patterns ======
  * For an A or V pattern without significant oblique dysfunction, moving the horizontal rectus vertically at the time of strabismus surgery can eliminate the pattern
  * A-Pattern
    * > 10 Prism Diopters in Upgaze vs Downgaze
    * Move the medials UP 1/2 to 1 tendon width
    * Move the laterals DOWN 1/2 to 1 tendon width
  * V-Pattern
    * > 15 Prism Diopters in Upgaze vs Downgaze
    * Move the medials DOWN 1/2 to 1 tendon width
    * Move the laterals UP 1/2 to 1 tendon width
  * Surgery on the appropriate oblique muscles if they are dysfuctional can also treat the pattern
  * References:
    * [[https://childrenseye.org/filerun/FileRun/wl/?id=XcaSwx7P4yej0nas70HOL3MBiCPN3hFE | The Effect of Vertical Displacement of Horizontal Muscles on the Deviation in Primary Position. Kutsche and Keech 1988.]]
    * [[https://childrenseye.org/filerun/FileRun/wl/?id=adtG5cinz6fxLxgzVcTgV0l7koOzBJRL | Vertical offsets of horizontal recti muscles in the management of A and V pattern strabismus. Scott, Drummond, Keech 1989.]]
 
{{:a_v_patterns.png?600 |}}

{{tag>strabismus_surgery}}