Dissociated Vertical Deviation with Microtia showing Familial Tendency

ABSTRACT

PURPOSE: We report two brothers having dissociated vertical deviation with microtia and familial history of the condition. METHODS: The subjects of this report are a 7-year-old patient with bilateral dissociated vertical deviation, exotropia, bilateral inferior oblique muscle overaction, and microtia, and his brother, a 6-year-old with bilateral dissociated vertical deviation, right dissociated horizontal deviation and microtia. RESULTS: The first patient underwent asymmetric bilateral lateral rectus muscle recession and bilateral inferior oblique muscle myotomy, while the second patient had asymmetric bilateral lateral rectus muscle recession. In the first patient, the exotropia was corrected, but the bilateral dissociated vertical deviation and left dissociated horizontal deviation remained. The right dissociated horizontal deviation improved in the second patient. Their father, two aunts and paternal grandmother also had strabismus and microtia. CONCLUSIONS: Physicians must investigate familial history in examining the strabismus patient with microtia. Additionally, genetic investigation is in need in more subjects of this study.