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Strabismus

Strabismus, also known as "heterotropia", "squint", "crossed eye", "wandering eye", or "wall eyed", is a disorder in which the eyes do not point in the same direction. It typically involves a lack of coordination between the extraocular muscles which prevents bringing the gaze of each eye to the same point in space, preventing proper binocular vision, which may adversely affect depth perception. The cause of strabismus can be a disorder in one or both of the eyes; for example, nearsightedness or farsightedness, making it impossible for the brain to fuse two different images. more...

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When strabismus is congenital or develops in infancy, it can cause amblyopia, in which the brain ignores input from the deviated eye although it is capable of normal sight. Since strabismus can cause amblyopia, which is sometimes referred to as lazy eye, it is sometimes itself inaccurately referred to as lazy eye.

In addition to the visual problem, strabismus can be considered a cosmetic problem owing to the appearance of the deviated eye. One study reported that 85% of adult strabismus patients "reported that they had problems with work, school and sports because of their strabismus". The same study also reported that 70% said strabismus "had a negative effect on their self-image" .

Types

Strabismus may be concomitant or incomitant. Concomitant strabismus means that the strabismus is equal regardless of which direction the gaze is targeted. This indicates that the individual extraocular muscles function individually, but that they may simply not be aimed at the same target. Concomitant strabismus in a child under the age of 6 rarely indicates serious neurologic disorder. Blindness in one eye usually causes concomitant strabismus, with the eye of a child turning inward, and that of an adult turning outward.

Incomitant strabismus occurs when the degree of misalignment varies with the direction of gaze. This indicates that one or more of the extraocular muscles may not be functioning normally. Types of strabismus include:

  • esotropia, or one eye turning inward;
  • exotropia, or one eye turning outward;
  • hypertropia, or one eye turning upward.
  • hypotropia, or one eye turning downward.

Medial strabismus manifests as the inability to abduct (move laterally) one's eye. This is usually caused by damage to the abducens nerve or abducens nucleus. The result is that the eye in its normal resting state deviates medially, as the movements of the medial rectus muscle are less opposed by the denervated lateral rectus muscle.

Pseudostrabismus is the false appearance of strabismus. It generally occurs in infants and toddlers whose bridge of their nose is wide and flat. This causes the appearance of strabismus. With age the child's bridge of their nose will narrow and the folds in the corner of the eyes will go away. To detect the difference between pseudostrabismus and strabismus use a flashlight and shine it in the child's eyes. When the child is looking at the light a reflection can be seen on the front surface of the pupil. If the eyes are properly aligned with one another then the reflection will be in the same spot of each eye. If strabismus is present, then the reflection from the light will not be in the same spot of each eye.

Read more at Wikipedia.org


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Good on their feet: 'Dirty Rotten Scoundrels' & 'Spelling Bee'
From Commonweal, 6/17/05 by Celia Wren

The art of the con is alive and well--just take a look at my mailbox. The latest Williams Sonoma catalog suggests that I buy a hand-forged branding iron for monogramming steaks; a brushed-stainless-steel cream whipper; a mozzarella slicer (what ever happened to the good old-fashioned knife?); and a machine that will plaster salt along the rims of my margarita glasses. I don't have margarita glasses--in fact, I don't drink margaritas or eat steak--and yet, the activity of turning the catalog's glossy pages fills me with a sensation of comfort. I yearn to whip out my credit card. I have succumbed to hucksterism.

We occasionally like being swindled--were it not so, would we have generated a culture that barrages us with advertising for absurdly unnecessary products? No wonder, then, that the early months of 2005 saw the Broadway premiere of an exuberant musical about swindlers. David Yazbek and Jeffrey Lane's Dirty Rotten Scoundrels is based on the 1988 movie of the same title. Directed by Jack O'Brien, the musical stars John Lithgow and Norbert Leo Butz (who won a Tony for his performance) as two charlatans scamming rich folk on the Riviera. Lithgow takes the role of the aristocratic Lawrence Jameson (the figure Michael Caine played in the movie), while Butz slums around superbly as the crass Freddy Benson (the Steve Martin part in the movie), who vies with Lawrence to defraud an American ingenue, Christine Colgate (Sherie Rene Scott).

As some reviewers noted, Dirty Rotten Scoundrels is the second flashy musical about lovable con men to have opened on the Great White Way in recent years, the other, of course, being The Producers. Less jam-packed with sublimely comic moments, Scoundrels can't quite rival the Mel Brooks juggernaut, but it's a smart and delightful show in its own right, and it boasts a trio of exceptional performers in the leads. Con men everywhere deserve to be proud.

Book author Lane, an Emmy-winning TV writer, has added a romantic subplot involving a corrupt police chief. Otherwise he has hewn closely to the movie storyline--right down to the goofy scene in which Freddy impersonates Lawrence's lecherous, mentally handicapped brother. Matching the narrative's zanyness, Yazbek's music has an appealing tongue-in-cheek tone, from the loony, pouncing melody in the overture (reminiscent of the theme from the Pink Panther movies) to the velvety cabaret sound of the conman credo "Give Them What They Want," to the yodels and oompa-pah-pah beat of "Ruffhousin' mit Shuffhausen."

Yazbek's sly lyrics are what really give Scoundrels panache. In accordance with a classic principle of musical-theater writing, the songs contribute to the characterizations; but the rhymes and references Yazbek uses are so ingenious and hilarious that the lyrics can virtually stand on their own. In the duet "Nothing Is Too Wonderful To Be True," for example, the romantic Christine marvels at the beauty of the moon, while the topic of "wonderful" happenings leads Freddy to muse, "I knew this guy at camp / Who ate his t-shirt on a dare. / My hotel gives away free shampoo. / Nothing is too wonderful to be true."

In the musical's best number, "Great Big Stuff"--a quasi-hip-hop anthem delivered by Butz with such verve that it must surely rank among the season's best theatrical moments--Freddy realizes that his criminal ambitions have skyrocketed since his arrival at Jameson's mansion: "I'm tired of being a chump / I wanna be like Trump / Two hundred pounds of caviar in one gigantic lump ... A house in the Bahamas--/ Paisley silk pajamas--/ Poker with Al Roker and our friend Lorenzo Lamas." This sassy lyric writing harkens back to the days of Cole Porter and Rodgers and Hart.

Words also take center stage in The 25th Annual Putnam County Spelling Bee, a charming and unusual piece that's the season's Little Musical That Could. Created by the Tony-winning composer/lyricist William Finn, with book by Rachel Sheinkin, concept by Rebecca Feldman, and direction by James Lapine, Spelling Bee originated at a lesser-known regional theater, Barrington Stage Company in Massachusetts. When it appeared at New York City's Second Stage Theatre, it proved such a sensation that it moved to Broadway, and will likely launch a national tour next season--a heady track record for a show about school kids at a spelling bee.

But what a bunch of oddball school kids they are, and what quirky stories they represent, from the solemn waif Olive Ostrovsky (Celia Keenan-Bolger), whose mother has absconded to an ashram; to Logainne Schwartzandgrubenierre (Sarah Saltzberg), whose upbringing by two gay fathers has turned her into a wunderkind of progressivist awareness; to William Barfee (Tony-winner Dan Fogler), who has a rare mucous membrane disorder and spells words on the floor with his foot. These young misfits compete to spell words like "strabismus" and "boanthropy," the twists and turns of the competition inspiring bursts of music, like the explosive ensemble number "Pandemonium" or the wily character sketch "I Speak Six Languages" (superbly rendered by the dancing/singing/piano-playing Deborah S. Craig as a stressed-out overachieving child, Marcy Park).

At each performance, several audience members are invited to join the spelling contest, sitting in the bleachers with the cast until they misspell a word. Some of the production's visual elements also usher spectators inside the theatrical illusion: blue and yellow athletic banners suspended from the walls and ceiling turn the entire Circle in the Square Theater into a school gymnasium, while mock bulletin boards in the theater's lobby extend the school-environment trope even further (set design is by Beowulf Boritt).

Fortunately, for those of us who remember school gymnasiums as sources of humiliation and terror, Spelling Bee doesn't overdo the implicate-the-audience motif. This isn't a show about preadolescent experience in general, or even spelling bees in general: it's a very specific story, filled with idiosyncratic detail, including a surprise appearance by Jesus. Particularly loopy and delightful are the tics of one particular adult character, Vice Principal Douglas Panch (Jay Reiss), who invents marvelously weird sentences to contextualize the words contestants need to spell (for the word "phylactery": "Billy, put down that phylactery: we're Episcopalians!").

We never find out too much about this eccentric vice principal, but his presence helps conjure up a fictional world that's satisfying because it's so complete and so whimsical. Storytellers, including those who work in theater, are the best kind of con artists. Who wouldn't rather succumb to an enthralling narrative than find space in the kitchen for that hand-forged steak-monogramming iron?

COPYRIGHT 2005 Commonweal Foundation
COPYRIGHT 2005 Gale Group

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