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    By David L. Guyton, MD
    Subspecialty Day 2012: Pediatric Ophthalmology
    Pediatric Ophth/Strabismus

    This case was a first for Dr. David L. Guyton. It was the first time in 22 years that he made a patient significantly worse with strabismus surgery, and in a way he could not repair. The patient was a 72-year-old male who acquired Brown’s syndrome after sinus surgery. Dr. Guyton performed a complete tenotomy, followed by a large right inferior oblique myectomy. The patient left the office with a diagnosis of postop adherence syndrome. The only thing he could do for him was tape off the entire right lens of his glasses except for a small peephole 5 mm in height and 9 mm in width, which was the only area within which he could see singly. He offers the lessons he learned from this case.