Congenital Levator-Inferior Rectus Synkinesis

ABSTRACT

We examined a 4-year-old girl who had showed retraction of the left upper eyelid on downward gaze since birth. She had no history of birth trauma, eye surgery, or oculomotor nerve palsy. Corrected visual acuity was 0.3 OU. Motility examination revealed no phoria or tropias. Full ductions and versions were present in all fields of gaze. In primary gaze, the upper eyelids were in normal position and symmetric, and the levator function of the both eyes was normal. On downward gaze, the left upper eyelid was retracted 3.5 mmcompared with the right upper lid. On left and downward gaze, the left upper lid retraction increased to 8 mm. Result of computed tomography of brain and orbits was normal. This case is clinically rare and may be the first report of congenital levator-inferior rectus synkinesis in the Korean literature.