Management of congenital fibrosis of the inferior rectus muscle associated with high myopia: a case report

BACKGROUND: Congenital fibrosis of the extraocular muscles includes a wide spectrum of phenotypically heterogeneous disorders involving a single or multiple muscles. METHODS: We present a case of congenital fibrosis of the inferior rectus associated with ipsilateral high myopia. First we tried to treat the hypotropia with inferior rectus weakening and superior rectus strengthening procedures, but this failed, so we proceeded with an ocular sling with fascia lata and a vertical Hummelsheim procedure. RESULTS: Hypotropia improved completely after the last operation and some degree of upward movement appeared. CONCLUSION: It seems that in a highly myopic globe with fibrotic muscles, classical methods for the correction of deviation may have poor response and more innovative procedures may be required to correct the deviation.