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This 8-year-old girl presented with a history of having eyes that deviated outward since birth. In addition, the eyes move little if at all in any direction. Vision is OD 20/40 and OS 20/100. Refraction is OD + 0.50 + 2.00 X 80 and OS +0.50 + 1.00 X 105. The remainder of the eye examination was normal including pupil reaction. She denies diplopia and has no ocular symptoms. Her general health is good. No other family member is affected.

1.	The most likely diagnosis in this case is:
	a. bilateral congenital third nerve palsy b. double elevator palsy c. "no name" triad d. congenital fibrosis of the extraocular muscles e. none of the above
2.	This condition is:
	a. fairly common b. rare c. a recessive trait d. treated effectively with steroids e. (b) and (c)
3.	When it comes to treatment:
	a. the appropriate medical regimen is usually effective b. it is very difficult to achieve good results c. two stage surgery can usually restore alignment with nearly full movement d. is best undertaken after age 15 years e. none of the above

For answers to the above, click here on or after January 11, 2011.