The ophthalmologist clinic of Beijing Children's Hospital recently received an unusual child, Xiao Liang (pseudonym).
Xiao Liang did not open his eyes for 3 days after he was born, and when he began to open his eyes, parents found that they could not see the "black eyeball" of the child's right eye. Parents took their children to major hospitals for treatment, and were diagnosed with "congenital small eyeballs" and "orbital tumors". The child is young and complex, and many professional doctors recommend treatment to Beijing Children's Hospital.
When Li Ningdong, chief physician of the Department of Ophthalmology of Children's Hospital, was first treated, Xiao Liang was only 46 days old, and the right cornea was hidden in the lower eyelid. After detailed examination and consultation with the imaging center and ophthalmic orbital specialists, Xiao Liang was diagnosed with "congenital right eye extraocular muscle fibrosis".
The child's right cornea, also known as the black eyeball, is hidden in the lower eyelid. In this case, the right eye will be unable to receive visual stimulation for a long time, severe amblyopia will occur, and visual function will be lost. In addition, the disease will also seriously affect the appearance of Xiao Liang and damage the physical and mental health of the child, so it is necessary to treat it as soon as possible.
Performing complex extraocular muscle surgery for children less than 100 days under general anesthesia carries a certain risk: it not only requires the surgeon to have skilled surgical experience, but also shortens the duration of surgery. At the same time, in order to reduce the impact on the child's whole body, there must be a strong anesthesia team.
After full preoperative preparation, with the strong support of the medical office, anesthesia department and other departments, Li Ningdong performed surgery for Xiao Liang, who had just turned two months old. During the operation, it was found that the external muscles of the small bright eyes were severely stunted and inelastic, especially the contracture of the right eye rectus muscle was more serious, and the eyeball was fixed in the lower transposition, so that the eyeball could not be rotated up at all. The child is young, the orbital area is narrowly anatomically narrow, and it is almost impossible to look directly into the muscle to be hooked.
In the end, with years of rich clinical experience, Li Ningdong almost completely relied on the feel to take the contracture of the inferior rectus muscle from the deep orbital hook. At the moment when the inferior rectus muscle was severed, the restrictive factor of the small bright eyeball was lifted, and the black eyeball that was "hidden" appeared in front of everyone. The operating room was full of cheers.
Under the meticulous care of the medical staff of the Children's Hospital, Xiao Liang did not show any general discomfort symptoms after the operation, and his right eye was already in the middle position when he was discharged. Xiao Liang's visual development is in a critical period, and early surgery can make his right eye receive stimulation from the external visual environment earlier, providing a better guarantee for future vision development.
Through literature review, it was found that Xiao Liang is currently the youngest child in the world to undergo restrictive lower strabismus surgery. The successful treatment of Li Ningdong and the multidisciplinary team of Beijing Children's Hospital not only saved Xiao Liang's vision in time, restarted the road of light for him, but also brought new hope to his family.