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Hypotropia is the similar condition, focus being on the eye with the visual axis lower than the fellow fixating eye. Dissociated vertical deviation is a special type of hypertropia leading to slow upward drift of one or rarely both eyes, usually when the patient is inattentive.
Hypotropia or hypertropia. In cases of vertical deviations, patients will report that: They see 5 lights: 2 red and 3 green; The lights are vertically displaced in relation to one another; The green lights (left eye) are on top of the red lights (right eye), which is interpreted as : R HT or LHypoT
Skew deviation is an unusual ocular deviation , wherein the eyes move upward (hypertropia) in opposite directions. Skew deviation is caused by abnormal prenuclear vestibular input to the ocular motor nuclei, most commonly due to brainstem or cerebellar stroke. Other causes include multiple sclerosis and head trauma.
When the covered eye is the non-amblyopic eye, the amblyopic eye suddenly becomes the person's only means of seeing. The strabismus is revealed by the movement of that eye to fixate on the examiner's finger. There are also vertical tropias (hypertropia and hypotropia) and cyclotropias.
Depending on the symptoms, the surgical correction of cyclotropia may involve a correction of an associated vertical deviation (hyper- or hypotropia), or a Harada–Ito procedure or another procedure to rotate the eye inwards, or yet another procedure to rotate it outwards.
Method for measuring vertical deviations: 1. The Maddox Rod is held in front of the patient's right eye with the cylinders vertical, making the red line horizontal. 2. The patient is then asked whether the white light is superimposed on the red line or if it appears above or below the red line.
Hypertropia/Hypotropia In a patient with an unsuppressed vertical deviation, one line will appear higher than the other. If the image of the right eye is higher than that of the left, this means the right eye is lower than the left.
Types include esotropia, where the eyes are crossed ("cross eyed"); exotropia, where the eyes diverge ("lazy eyed" or "wall eyed"); and hypertropia or hypotropia where they are vertically misaligned. They can also be classified by whether the problem is present in all directions a person looks (comitant) or varies by direction (incomitant). [3]
The Parks–Bielschowsky three-step test, also known as Park's three-step test or Bielschowsky head tilt test, is a method used to isolate the paretic extraocular muscle, particularly superior oblique muscle and trochlear nerve (fourth cranial nerve), in acquired vertical double vision.
For an abnormal result, based on where the light lands on the cornea, the examiner can detect if there is an exotropia (abnormal eye is turned out), esotropia (abnormal eye is turned in), hypertropia (abnormal eye higher than the normal one) or hypotropia (abnormal eye is lower than the normal one).