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This is a case report of an eight-year-old child with gradual progressive strabismus (esotropia and hypotropia) from the age of five years. The angle measured >45 degrees esotropia and 10 degrees hypotropia. There was a depressed linear-localised scar over the right frontal area toward the eyebrow and no history of trauma. Visual acuities were 6/6 and the right eyes was fixed in position. A diagnosis of strabismus fixus, enophthalmos, en coup de sabre scar and unilateral linear scleroderma. Surgery was undertaken involving medial rectus recessions, inferior rectus recession, half tendon loop myopexy of the superior rectus and lateral rectus recession. The medial rectus muscle split during surgery due to tightness. Postoperatively there was a consecutive exotropia of 14PD. The en coup de sabre scar was a key part of this diagnosis and the authors recommend screening of children with this.

A case of linear scleroderma ‘en coup de sabre’ with strabismus fixus in a child.
Sen P, Ramawat E, Mohan A, Shah C.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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