This study used high resolution MRI to demonstrate and evaluate globe shape in axial high myopia and identify and characterise those with prominent equatorial staphylomata that deflect extraocular muscle paths and presumably alter motility patterns in strabismus. The study included 21 cases; 14 were female. Good imaging was possible in 36 eyes. Ten were myopic globes and six were generally spherical. Fifteen globes showed diffuse posterior staphylomata, 16 showed equatorial staphylomata and four had both posterior and equatorial staphylomata. Axial length averaged 28.8±3.8mm. Myopes with staphylomata were older than those with spherical globes – all other clinical features were similar. The author proposes that these irregular staphylomata are positioned such that they may contact and elongate paths of extraocular muscles causing impaired ocular motility. 

Knobby eye syndrome.
Demer JL.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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