[Amblyopia of the fellow eye in assumed unilateral congenital fibrosis syndrome].
BACKGROUND: Amblyopia of the ptotic eye in spite of head posturing and of the fellow eye in ptosis with motility disorders are well known. We emphasize the importance of exact ophthalmological and orthoptic examinations to avoid amblyopia in both ptosis and fellow eye, even in cases of mild ptosis, especially if they are combined with motility disorders. PATIENT: A 5 year-old girl presented to our outpatient clinic because of ptosis of the left eye and hypertropia of the right eye. Visual acuity of the right eye was 0.32 and of the left ptotic eye 1.0. Cycloplegic retinoscopy showed + 2.0 sphere in both eyes. Ocular motility showed a mild reduction of elevation of the left eye in ad- and abduction. This led to the diagnosis of congenital fibrosis syndrome of the inferior rectus muscle of the left eye. Due to the preferred fixation with the left ptotic eye and the consecutive deviation of the fellow eye amblyopia of the right eye had developed. Occlusion therapy of the left eye resulted in an improvement of visual acuity of the right eye to 0.9 and centralisation of fixation within one month. CONCLUSION: Even children with mild ptosis, especially in combination with motility disorders, require a complete ophthalmological and orthoptic examination to avoid amblyopia also of the fellow eye.