ABSTRACT

ABSTRACT: A retrospective review of case notes was carried out of referrals over the past 5 years, from our Ocular Oncology service of patients treated with a plaque for uveal malignant melanoma, that developed ocular motility problems after the removal of the plaque. There were 9 males and 6 females, with an average age of presentation of 56 years. In 5 cases the superior oblique was disinserted. The other muscles reported as disinserted were the lateral rectus, inferior oblique, inferior rectus, superior rectus and medial rectus. Three patients did not have muscles removed. Six patients developed vertical strabismus, 2 horizontal, the other patients were aware of diplopia in different positions of gaze post removals. Eleven patients complained of diplopia. The 4 patients without diplopia developed central scotomas. Five patients were treated with fresnel prisms, 3 underwent successful superior oblique surgery, one had inferior rectus surgery, 4 had botulinum toxin and 2 patients had no treatment. Treatment using plaques can result in troublesome diplopia but can be treated with prisms, botulinum toxin or surgery.