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Objective: To present the clinical findings, surgical procedure and long-term outcome of a Thai patient with myopic strabismus fixus.
Case presentation: The patient presented with recurrent progressive esotropia and hypotropia. Two strabismus surgeries were performed 20 years ago. Magnetic resonance imaging (MRI) findings indicated the etiology which was secondary to inferiorly deviated lateral rectus (LR) muscle and medially deviated superior rectus (SR) muscle. The patient had undergone loop myopexy of lateral rectus and superior rectus muscles augmented with scleral fixation and satisfactory result was achieved up to six years after the operation.
Conclusion: The patient with myopic strabismus fixus should be evaluated by MRI to confirm the etiology of this disorder. Marked esotropia and hypotropia can be safely aligned by simple loop myopexy augmented with scleral fixation.