Dr.Jyoti Matalia, Dr.Sheetal Shirke, Dr.Shetty Bhujang K
This video describes an incidental detection of benign intracranial hypertension (BIH) with comitant esotropia in an infant with bilateral congenital cataract and its successful management by surgery. It highlights the importance of a detailed ophthalmic evaluation and illustrates the role of B scan in diagnosis and follow-up of BIH. We describe 8 months baby who underwent cataract surgery bilaterally and later, optic nerve sheath decompression (ONSD). The details of the surgical steps of ONSD by the transconjunctival route are vividly described. At the same sitting, she underwent simultaneous medial rectus recession to control her esotropia. Eventually, there was total resolution of the papilledema with attainment of orthotropia followed by an improvement in her vision and she started attaining milestones comparable to her age. It emphasizes the role of ONSD in a refractory case of BIH with comitant esotropia with simultaneous correction of the strabismus with satisfactory result.