Clinical Observation on a Case of Double Elevator Paralysis

ABSTRACT

Double elevator paralysis is a syndrome in which the superior rectus and the inferior oblique muscle of the same eye are paralyzed. The authors have experienced a case of double elevator paralysis with 35 prism diopters hypotropia and 20 prism diopters exotropia on the right eye. The patient was 19 years old female who visited our hospital because of poor cosmetic appearance. Knapp procedure was performed primarily to correct hypotropia, but 20 prism diopters hypotropia remained. 5 months later, a second operation was performed consisted of 7.5 mm recession of the left lateral rectus and 5mm recession of the right inferior rectus in order to correct the exotropia and residual hypotropia. After the second operation, ocular position in primary position was nearly orthophoric and upward movement of the right eye was considerably improved.