Another form of scapular fixation, although not commonly done in FSHD, is tendon transfer, which involves surgically rearranging the attachments of muscles to bone. Examples include pectoralis major transfer and the Eden-Lange procedure. Various other surgical reconstructions have been described. Upper eyelid gold implants have been used for those unable to close their eyes. Drooping lower lip has been addressed with plastic surgery. Select cases of foot drop can be surgically corrected with tendon transfer, in which the tibialis posterior muscle is repurposed as a tibialis anterior muscle, a version of this being called the Bridle procedure. Severe scoliosis caused by FSHD can be corrected with spinal fusion; however, since scoliosis is a compensatory change in response to muscle weakness, correction of spinal alignment can result in further impaired muscle function. Scapular winging management

Prognosis
Genetics partially predicts prognosis. Those with large D4Z4 repeat deletions (with a remaining D4Z4 repeat array size of 10-20 kbp, or 1-4 repeats) are more likely to have severe and early disease, as well as non-muscular symptoms. Those who have the genetic mutations of both FSHD1 and FSHD2 are more likely to have severe disease. It has also been observed that disease manifestation is milder when a prominent family history is present, as opposed to a new mutation. In some large families, 30% of those with the mutation do not show symptoms, and 30% of those with symptoms do not progress beyond facial and shoulder weakness.
Intraocular hemorrhage is bleeding (hemorrhage) inside the eye (oculus in Latin) . It may be the result of physical trauma (direct injury to the eye) or other diseases, injuries or disorders (such as diabetes, hypertension, or shaken baby syndrome). Severe bleeding may cause high pressures inside the eye, leading to blindness. Types
The types of ocular hemorrhages are classified based on where the bleeding is occurring:

Subconjunctival hemorrhage (bleeding just underneath the conjunctiva)
Intraocular hemorrhages:
Hyphema (in the anterior chamber)
In the posterior segment of eyeball:
Vitreous hemorrhage (into the vitreous)
Subretinal hemorrhage (under the retina)
Submacular hemorrhage (under the macula)

Causes
Different causes may cause bleeding in different locations. Tersons syndrome (as a result of subarachnoid hemorrhage)
Hemophilia (a severe bleeding disorder, usually hereditary)
Anticoagulants and thrombolysis (medication to reduce blood clotting tendency or to disperse blood clots, respectively)The major causes of bleeding are injury diabetes mellitus hypertension. Diagnosis
Intraocular hemorrhage is typically diagnosed with slit lamp examination. Treatment
References


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