BACKGROUND Hypertropia is a condition in which one eye is elevated relative to the other, either intermittently or constantly. It causes significant problem either cosmetically or by abnormal head posture and thus needs to be corrected surgically. This study was conducted to evaluate the success rate and complications of isolated inferior oblique myectomy in patients with hypertropia. METHODS...

OBJECTIVE To explore the mechanisms underlying the hypertropia associated with unilateral coronal synostosis. METHODS In 13 patients with unilateral coronal synostosis, we measured gaze-dependent binocular alignment before and after strabismus surgery, assessed the superior rectus muscle (SRM) pulley using computed tomography, and simulated posterior displacement of the trochlea and superolat...

INTRODUCTION Patients with superior oblique muscle palsy often assume a compensatory head tilt to the contralateral side of the affected eye. This tilt serves to decrease the hypertropia and, in theory, might decrease the excyclotropia. METHODS A prospective investigation was undertaken of the effect of forced head tilt to the right and left on torsion and the hypertropia in patients with uni...

PURPOSE To evaluate the correlation between hypertropia and excyclotorsion in acquired superior oblique palsy (SOP). METHODS Thirty-one patients with acquired unilateral SOP were recruited for this study. The torsional angle of each patient was assessed via one objective method (fundus photography) and two subjective methods (double Maddox rod test and major amblyoscope). The patient populati...

CLINICAL PEARLS Lesions of the fourth (trochlear) cranial nerve cause vertical or oblique diplopia by impairing the ability of the superior oblique muscle to intort and depress the eye. This binocular diplopia worsens in downgaze and lateral gaze away from the affected eye. Because intorsion is necessary to maintain fusion in ocular counter-roll, this diplopia also worsens with head tilt toward...

PURPOSE To evaluate the correction of hypertropia in primary position with unilateral inferior oblique (IO) anterior transposition (IOAT). METHODS Ten patients with idiopathic (nonparalytic, restrictive, or dissociated vertical deviation) hypertropia with marked IO overaction, who underwent unilateral IOAT, were prospectively evaluated to observe the correction of the hypertropia in primary p...

Purpose To report a case of inferior rectus muscle hypoplasia with esotropia, which was treated successfully by resection and anterior transposition of the inferior oblique muscle. Observations A 1-year-old boy presented with esotropia. He had esotropia of 15-30° and intermittent left hypertropia. At the age of 3 years, the alternate prism cover test showed esotropia of 35Δ and left hypertrop...

Although on cover test the child maintained fixation easily with either eye, he preferred to view with the right eye. A marked left convergent strabismus was present, the deviation being greater on accommodation; the cover test also showed alternating hypertropia. When fixing with the right eye the horizontal deviation was approximately 35A with left hypertropia and when fixing with the left ey...

PURPOSE To report a case of bilateral Brown's syndrome with unilateral spontaneous resolution causing hypertropia and significant head tilt. CASE REPORT A 3 ½-year-old girl presented with bilateral typical Brown's syndrome and orthophoria in the primary position; she presented with unilateral resolution of right Brown's syndrome 6 months later, causing right hypertropia and gradually deterior...

OBJECTIVE To evaluate the efficacy of treating Knapp class II superior oblique muscle palsy with 7-mm nasal transposition of the ipsilateral inferior rectus muscle combined with recession of the contralateral inferior rectus muscle when the primary position hypertropia is 10 prism diopters (PD) or less. METHOD A retrospective review of 8 consecutive patients with superior oblique muscle pares...