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Category: Volume 4 Issue 07 July 2016
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Title: Double Trouble- Double Elevator Palsy With Pseudoptosis A Case Report

Authors: Dr Preeti Rawat, Dr Vinanti Kangale, Dr Shashank Saxena, Dr Shweta Walia, Dr (Prof) Vijay Bhaisare, Dr Manushree Gautam, Dr Neetu Kori

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i7.04

Abstract

A monocular elevation deficiency is also known as Double elevator palsy. It suggests paralysis of both elevator muscles (the superior rectus and the inferior oblique) of same eye; resulting in clinical condition characterized by defective elevation in the entire range of upward gaze, (i.e. in primary gaze, in adduction and abduction) and a hypotropia in the primary gaze. It can be caused by paretic, restrictive or combined etiology. It may be either congenital or acquired. 50% presents with true ptosis due to associated hypotropia.

40% of the cases present with pseudoptosis. Pseudoptosis disappears when patient fixates with the paretic eye associated with hypertropia in uninvolved eye.

We present a case of 6 years old male patient having right eye congenital monocular elevation deficiency with pseudoptosis.

Keywords- Double elevator palsy, hypotropia, Pseudoptosis

References

    

1.      White JW (1942) paralysis of the superior rectus and the inferior oblique muscle. Arch  ophthalmmol 27: 336-371.

2.      Dunlap EA. Vertical displacement of horizontal recti; Symposium on strabismus transactions of the New Orleans Academy of Ophthalmology; St Louis: Mosby; 1971. pp. 307–329.

3.      Rosenbaum AL, Santiago AP. Clinical strabismus management.principles and surgical techniques. W.B. Saunders Company 1999.p.272-9

4.      Wright K,Spigel PH. Paediatric ophthalmology and strabismus. 2nd ed. Springer:2003.p. 257-8.

5.      Kataria Sneha et al. Double Elevator Palsy (Monocular Elevation Deficit): An Update. Surgical Techniques in Ophthalmology. Strabismus Surgery (2011): 264. \

6.      Bandyopadhyay Rakhi, Shashikant Shetty and P. Vijayalakshmi. Surgical outcome in monocular elevation deficit: A retrospective interventional study. Indian journal of ophthalmology 56.2 (2008): 127. |

7.      Yurdakul, Nazife Sefi, Seyda Ugurlu and Ahmet Maden. Surgical treatment in patients with double elevator palsy. European journal of ophthalmology 19.5 (2009): 697. |

8.      Rosenbaum AL. Clinical strabismus management. 1st ed. Philadelphia: WB Saunnders; 1999. |

Corresponding Author

Dr Vinanti Kangale

MGM Medical College, Indore, India

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