Special forms of strabismus

In previous chapters we discussed types of strabismus where the deviation of the eyes is horizontal, inwardly or outwardly. Less frequently, strabismus may relate to vertical positions, which means that one eye is higher (hypertropia) or lower (hypotropia) from the eye that’s fixed on an object.

Vertical strabismus is generally not consistent which means that the angle of the eyes is increased or decreased depending on their position.

Most children are able to counteract diplopia by tilting their head in such a position that the eyes are aligned. As the deviation itself is often difficult to grasp, this is the first point that parents notice and that leads them to a pediatrician or an ophthalmologist.

The important types of vertical deviations are the inferior oblique hyperfunction, the superior oblique hyperfunction and the disconnected vertical deviation.

 

Hyperfunction of the inferior oblique muscle

Hyperfunction of the inferior oblique muscle

The movement of the eye caused by the lower oblique oculomotor muscle is upwards and inwardly (nasally).

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Hyperfunction of the superior oblique muscle

Hyperfunction of the superior oblique muscle

The movement of the eye caused by the superior oblique oculomotor muscle is downwards and inwardly (nasally).

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Unbonded vertical deviation (DVD)

Unbonded vertical deviation (DVD)

The unbonded vertical deviation, also known as DVD (Dissociated Vertical Deviation), is the phenomenon of the upper rotation of the eye when it is covered.

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Congenital paralysis of the superior oblique

Congenital paralysis of the superior oblique

The superior oblique muscle is innervated by the fourth cranial nerve (trochlear) and its effect is to shift the eye downwardly and inwardly (nasally).

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A and V phenomena

A and V phenomena

The V phenomenon is mainly seen in the bilateral hyperfunction of the lower oblique muscles, while the phenomenon A in the hyperfunction of the bilateral...

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 Duane syndrome

Duane syndrome

It is a rare congenital syndrome of strabismus, characterized by the restriction of eye movements, retraction of the eye and stenosis of the palpebral...

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Brown syndrome

Brown syndrome

Brown syndrome is designated by the inability of the eye to look up, when in adduct position

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