A 36-year-old woman presented with vertical diplopia, nausea, and disequilibrium. Maddox rod testing was performed in the upright and supine positions (figures 1 and 2). Skew deviation is a vertical misalignment caused by a supranuclear lesion in the vertical vestibuloocular reflex pathways, including the vestibular nerve, brainstem, or cerebellum. It arises from perturbed utricular inputs, and...

PURPOSE To report the clinical features of a rare case of hypotropic dissociated vertical deviation (DVD). CASE REPORT A 25-year-old female was referred with unilateral esotropia, hypotropia and slow variable downward drift in her left eye. She had history of esotropia since she had been 3-4 months of age. Best corrected visual acuity was 20/20 in her right eye and 20/40 in the left one when ...

Aim: Vertical incomitance can occur after muscle surgery, reasons remain unknown. In a prospective study, incidence and treatment was analysed. Material and methods: 40 consecutive esotropes where uniocular recession and resection was done were included in this study. First 20 had standard recession –resection and the rest 20 had hang back medial rectus recession along with resection andsplitti...

Abnormalities in visually evoked responses have been used to demonstrate abnormal optic nerve fibre projections in human albinos, who have anomalous nystagmoid movements. Using visually evoked potentials we tested the hypothesis that patients with dissociated vertical deviation (another group with anomalous nystagmoid movements) may have abnormal visual evoked responses similar to those of albi...

AIM To evaluate the outcome after surgery for unilateral superior oblique (SO) palsy in Chinese. METHODS The medical records of 39 patients that underwent surgery for unilateral SO palsy between January 2003 and December 2012 at Caritas Medical Centre, Hong Kong, were retrospectively reviewed. All surgeries were performed by a single surgeon. Pre-operative assessments for vertical deviation, ...

Skew deviation is a vertical strabismus caused by a supranuclear lesion in the posterior fossa. Because skew deviation may clinically mimic trochlear nerve palsy, it is sometimes difficult to differentiate the 2 conditions. In this review we compare the clinical presentations of skew deviation and trochlear nerve palsy and examine the pathophysiology that underlies skew deviation. We then descr...

BACKGROUND Inferior oblique muscle overaction of variable amounts is usually present with congenital superior oblique palsy. Inferior oblique muscle anteriorization has been described as a suitable surgical procedure in this entity. The aim of this study was to investigate the effect of inferior oblique muscle anteriorization in patients with congenital superior oblique palsy on vertical, torsi...