{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:06:44Z","timestamp":1756339604779,"version":"3.44.0"},"reference-count":29,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,12,28]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>Patients with syndromic craniosynostosis are usually associated with the complexity of the malformation complex. We describe here detailed oculo-motility disorder and a remarkable finding of hypoplastic bilateral media recti on imaging and its intraoperative absence in patients with phenotypic features resembling Shprintzen-Goldberg syndrome (SGS). SGS is a rare congenital disorder with craniosynostosis affecting multiple systems including mentation and having a considerable overlap of its phenotypic features with Marfan syndrome. Large A-pattern exotropia found in these patients may be related to the craniofacial features and their bearing on extraocular muscle development and function. In this paper, we aimed to sensitise ophthalmologists and strabismologists concerning the necessity to recognise syndromic associations of patients with craniosynostosis presenting with a large squint, be aware of the intraoperative surprises and consider the challenges in its management.<\/jats:p>","DOI":"10.1136\/bcr-2019-233557","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T11:55:23Z","timestamp":1610970923000},"page":"e233557","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Intraoperative absent bilateral medial recti in syndromic craniosynostosis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5565-3979","authenticated-orcid":false,"given":"Shweta","family":"Chaurasia","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"},{"name":"Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pradeep","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3719-4112","authenticated-orcid":false,"given":"Abhidnya","family":"Surve","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swati","family":"Chaurasia","sequence":"additional","affiliation":[{"name":"Department of Medicine, Sanjay Gandhi Memorial Hospital, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,1,18]]},"reference":[{"key":"2025082712480867000_14.1.e233557.1","doi-asserted-by":"publisher","DOI":"10.3928\/01913913-20121113-02"},{"key":"2025082712480867000_14.1.e233557.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1091-8531(98)90090-8"},{"key":"2025082712480867000_14.1.e233557.3","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/S0002-9394(14)70287-9","article-title":"Congenital absence of the inferior rectus muscle","volume":"121","author":"Mu\u00f1oz","year":"1996","journal-title":"Am J Ophthalmol"},{"key":"2025082712480867000_14.1.e233557.4","first-page":"375","article-title":"Congenital absence of the superior oblique tendon in craniofacial dysostosis","volume":"16","author":"Pinchoff","year":"1985","journal-title":"Ophthalmic Surg"},{"key":"2025082712480867000_14.1.e233557.5","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.jaapos.2006.11.112","article-title":"Absence of all cyclovertical extraocular muscles in a child who has Apert syndrome","volume":"11","author":"Bustos","year":"2007","journal-title":"J Aapos"},{"key":"2025082712480867000_14.1.e233557.6","doi-asserted-by":"crossref","first-page":"349","DOI":"10.3928\/0191-3913-19791101-04","article-title":"Absence of the superior rectus muscle in Apert's syndrome","volume":"16","author":"Cuttone","year":"1979","journal-title":"J Pediatr Ophthalmol Strabismus"},{"key":"2025082712480867000_14.1.e233557.7","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1965.00970040154003"},{"key":"2025082712480867000_14.1.e233557.8","first-page":"119","article-title":"Anomalous medial rectus muscle insertion in a child with craniosynostosis","volume":"16","author":"Coats","year":"2001","journal-title":"Binocul Vis Strabismus Q"},{"key":"2025082712480867000_14.1.e233557.9","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1002\/ajmg.a.31202","article-title":"Fbn1, TGFBR1, and the Marfan-craniosynostosis\/mental retardation disorders revisited","volume":"140","author":"Ad\u00e8s","year":"2006","journal-title":"Am J Med Genet A"},{"key":"2025082712480867000_14.1.e233557.10","doi-asserted-by":"publisher","DOI":"10.1007\/s10038-006-0078-1"},{"key":"2025082712480867000_14.1.e233557.11","unstructured":"Greally MT , Adam MP , Ardinger HH . 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