The test revealed that the ptosis increased after prolonged upgaze
and improved after the ice test which supported the preliminary diagnosis (Figure 3).
The patient described slight diplopia on upgaze
. Hess screen test showed normal SO function with -1 hypofunction in the IO muscles.
This is a vertical palsy, mostly affecting upgaze
, with pseudo Argyll-Robertson pupil and convergence retraction nystagmus.
Caption: Figure 2: Left unilateral exophthalmos with limitation in upgaze
and diplopia (double vision).
produces the greatest IOP elevation of all eccentric eye positions (mean: 6.8 mmHg) .
Benign paroxysmal tonic upgaze
of childhood in a hypotonic infant with Beckwith-Wiedemann syndrome.
A 40-year-old Hungarian woman suddenly noticed upgaze
diplopia and right cheek compression when she woke up in the morning.
Diabetic third nerve palsy presents with abrupt onset retro-orbital pain, followed by double vision, unilateral ptosis, restriction of medial and upgaze
and sparing of the pupil.
Monocular elevation deficiency (MED) is classified as three subtypes: 1) restrictive form, with features including positive forced duction test (FDT) for elevation, normal elevation forced generation test (FGT), and elevation saccadic velocity, often an extra or deeper lower eyelid fold on attempted upgaze
and poor or absent Bell phenomenon; 2) paretic form with elevator muscle weakness, with features including free FDT, reduced elevation FGT and saccadic velocity, in which the Bell phenomenon is often preserved; and 3) a combination form, with features including positive FDT for elevation and reduced FGT and saccadic velocity for elevation.
Her cranial nerves were notable for impaired upgaze
, but otherwise intact EOMs with slow tracking but no abnormal saccades and no nystagmus.
Patients who had apparent restriction in ocular motility especially upon upgaze
, pain on looking upward or apparent enophthalmous, surgery was carried out within 24 hours after trauma in order to alleviate any ischemic tethering the fracture site would impose on the orbital content.
Paroxysmal tonic upgaze
of childhood: effect of age-of-onset on prognosis.