Outcome of Strabismus Surgery for Exotropia in a 4-year-old with Silver-Russell Syndrome (SRS): A Case Report

Silver-Russell Syndrome (SRS) is a rare disorder associated with prenatal and postnatal growth retardation with
associated characteristic facial and ocular features including strabismus. We report the outcome of strabismus
surgery performed for exotropia in a 4-year-old patient with SRS.

The patient presented with decreased visual acuity and constant exotropia of the right eye noted since 3 months
of age. Systemic SRS characteristics consisted of relative macrocephaly, short stature, forehead prominence and
stunted growth pattern. An X-pattern exotropia is consistent with bilateral tight lateral recti muscles with overelevation in adduction of the left eye was present. Patient underwent unilateral right lateral rectus recession and right medial rectus resection for a 50-prism diopter constant exotropia. Patient had a favorable outcome of within 8 prism diopters from orthotropia at 1st, 3rd-, 6th- and 12th-month post-operatively.