Traumatic paralytic esotropia due to abducent nerve palsy is not uncommon but difficult to manage. It has less complex presentations having only the lateral rectus muscle affected with deviation in only horizontal plane and no torsional effect exists. Long standing cases also associate with medial rectus contracture of same eye due to unopposed action. Surgical treatment of sixth nerve palsy should be deferred whenever a chance for improvement exists and at least for the first 6 months after onset.
The original Hummelsheim procedure involves longitudinally splitting the superior and inferior rectus muscles and transposing each lateral half to the insertion of the paretic lateral rectus muscle. It transfers more force. The vertical rectus muscle transposition technique is a safe and successful method of treatment in abducens nerve palsy. Its use together with additional procedures and…
