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Henry S. Metz is an American pediatric ophthalmologist. He was the CEO of the Smith-Kettlewell Institute in San Francisco from 2003 to 2008. Much of his early research concerned eye movements and strabismus, including saccadic velocity measurements and use of botulinum toxin.
After completed his undergraduate degree from Columbia College, Columbia University, Metz received his medical degree from SUNY and MBA from the University of Rochester. He did a medical internship at the Jewish Hospital of Brooklyn, followed by an ophthalmology residency at the University of Rochester School of Medicine and strabismus fellowship at the Smith-Kettlewell Eye Research Institute. His fellowship preceptor was the renowned strabismologist Arthur Jampolsky. During the late 1990s Metz maintained private practice in Rochester and at The Eye Specialists Center in Illinois, and served as Visiting Professor at The University of Illinois Eye and Ear Infirmary until his appointment at Smith-Kettlewell in 2003.
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Botulinum toxin, or botulinum neurotoxin (BoNT), is a neurotoxic protein produced by the bacterium Clostridium botulinum and related species. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction, thus causing flaccid paralysis. The toxin causes the disease botulism. The toxin is also used commercially for medical and cosmetic purposes.
Strabismus is a vision disorder in which the eyes do not properly align with each other when looking at an object. The eye that is focused on an object can alternate. The condition may be present occasionally or constantly. If present during a large part of childhood, it may result in amblyopia, or lazy eyes, and loss of depth perception. If onset is during adulthood, it is more likely to result in double vision.
Duane syndrome is a congenital rare type of strabismus most commonly characterized by the inability of the eye to move outward. The syndrome was first described by ophthalmologists Jakob Stilling (1887) and Siegmund Türk (1896), and subsequently named after Alexander Duane, who discussed the disorder in more detail in 1905.
The superior rectus muscle is a muscle in the orbit. It is one of the extraocular muscles. It is innervated by the superior division of the oculomotor nerve (III). In the primary position, its primary function is elevation, although it also contributes to intorsion and adduction. It is associated with a number of medical conditions, and may be weak, paralysed, overreactive, or even congenitally absent in some people.
Sixth nerve palsy, or abducens nerve palsy, is a disorder associated with dysfunction of cranial nerve VI, which is responsible for causing contraction of the lateral rectus muscle to abduct the eye. The inability of an eye to turn outward, results in a convergent strabismus or esotropia of which the primary symptom is diplopia in which the two images appear side-by-side. Thus, the diplopia is horizontal and worse in the distance. Diplopia is also increased on looking to the affected side and is partly caused by overaction of the medial rectus on the unaffected side as it tries to provide the extra innervation to the affected lateral rectus. These two muscles are synergists or "yoke muscles" as both attempt to move the eye over to the left or right. The condition is commonly unilateral but can also occur bilaterally.
Marshall Miller Parks was an American ophthalmologist known to many as "the father of pediatric ophthalmology".
Strabismus surgery is surgery on the extraocular muscles to correct strabismus, the misalignment of the eyes. Strabismus surgery is a one-day procedure that is usually performed under general anesthesia most commonly by either a neuro- or pediatric ophthalmologist. The patient spends only a few hours in the hospital with minimal preoperative preparation. After surgery, the patient should expect soreness and redness but is generally free to return home.
Gene Folk was an American ophthalmologist who specialized in the diagnosis and treatment of strabismus. A charter member of the American Association for Pediatric Ophthalmology and Strabismus, he later served as President of this organization. With Martin Urist, Folk helped found the "Chicago" school of strabismus, whose ideas competed with and stimulated those of Marshall M. Parks, Arthur Jampolsky, and other prominent strabismologists. During the 1950s and 1960s, Urist and Knapp's contributions led to a much improved understanding of so-called A and V "pattern" strabismus, where the amplitude of deviation varies in up- and downgaze.
Burt Kushner is an American pediatric ophthalmologist specializing in the diagnosis and treatment of strabismus. Kushner's contributions include demonstration of improved visual fields of patients following strabismus surgery, elucidation of torsional contribution to patients with diplopia, corticosteroid treatment of periocular capillary hemangioma, and novel hypotheses on the mechanism of "overacting" extraocular muscles.
Infantile esotropia is an ocular condition of early onset in which one or either eye turns inward. It is a specific sub-type of esotropia and has been a subject of much debate amongst ophthalmologists with regard to its naming, diagnostic features, and treatment.
Jane Kivlin is an American ophthalmologist who specializes in the diagnosis and treatment of pediatrics genetics and strabismus. A longstanding member of the American Association for Pediatric Ophthalmology and Strabismus, she served as President of this organization. She is well known for her contributions to the understanding of amblyopia and the ophthalmologic manifestations of shaken baby syndrome.
Persistent Fetal Vasculature(PFV), known also as Persistent Fetal Vasculature Syndrome (PFSV), and until 1997 known primarily as Persistent Hyperplastic Primary Vitreous (PHPV), is a rare congenital anomaly which occurs when blood vessels within the developing eye, known as the embryonic hyaloid vasculature network, fail to regress as they normally would in-utero after the eye is fully developed. Defects which arise from this lack of vascular regression are diverse; as a result, the presentation, symptoms, and prognosis of affected patients vary widely, ranging from clinical insignificance to irreversible blindness. The underlying structural causes of PFV are considered to be relatively common, and the vast majority of cases do not warrant additional intervention. When symptoms do manifest, however, they are often significant, causing detrimental and irreversible visual impairment. Persistent Fetal Vasculature heightens the lifelong risk of glaucoma, cataracts, intraocular hemorrhages, and retinal detachments, accounting for the visual loss of nearly 5% of the blind community in the developed world. In diagnosed cases of PFV, approximately 90% of patients with a unilateral disease have associated poor vision in the affected eye.
Douglas Jabs is an American ophthalmologist and an expert in clinical research in the fields of ophthalmology and uveitis.
Elias I. Traboulsi is a physician in the fields of ophthalmic genetics and pediatric ophthalmology.
Cyclotropia is a form of strabismus in which, compared to the correct positioning of the eyes, there is a torsion of one eye about the eye's visual axis. Consequently, the visual fields of the two eyes appear tilted relative to each other. The corresponding latent condition – a condition in which torsion occurs only in the absence of appropriate visual stimuli – is called cyclophoria.
Botulinum toxin therapy of strabismus is a medical technique used sometimes in the management of strabismus, in which botulinum toxin is injected into selected extraocular muscles in order to reduce the misalignment of the eyes. The injection of the toxin to treat strabismus, reported upon in 1981, is considered to be the first ever use of botulinum toxin for therapeutic purposes. Today, the injection of botulinum toxin into the muscles that surround the eyes is one of the available options in the management of strabismus. Other options for strabismus management are vision therapy and occlusion therapy, corrective glasses and prism glasses, and strabismus surgery.
The management of strabismus may include the use of drugs or surgery to correct the strabismus. Agents used include paralytic agents such as botox used on extraocular muscles, topical autonomic nervous system agents to alter the refractive index in the eyes, and agents that act in the central nervous system to correct amblyopia.
Santosh Gajanan Honavar is an Indian ophthalmologist and is currently the editor of the Indian Journal of Ophthalmology and Indian Journal of Ophthalmology - Case Reports, the official journals of the All India Ophthalmological Society; Director, Medical Services ; Director, Department of Ocular Oncology and Oculoplasty at Centre for Sight, Hyderabad; and Director, National Retinoblastoma Foundation.
Alan Brown Scott was an American ophthalmologist specializing in eye muscles and their disorders, such as strabismus. He is best known for his work in developing and manufacturing the drug that became known as Botox, research described as "groundbreaking" by the ASCRS.
The Smith-Kettlewell Eye Research Institute is a nonprofit research institute in San Francisco, California, with a focus on vision science and rehabilitation engineering. It was founded in 1959 by Arthur Jampolsky and Alan B. Scott, when some members of Stanford University's Ophthalmology Department elected to stay in San Francisco rather than move to Palo Alto.
