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This 13-year-old boy has a huge exotropia which has been present since birth.  Visual acuity is OD 20/400 and OS 20/20.  Refraction is OD +1.50 and OS +1.00 +0.75 x 135.  Optic atrophy is present in the right eye.  This boy habitually turns his head to the right with eyes left.

1.	The pictures showing the boy with his gaze directed in the primary position, looking right, and looking left show the largest exodeviation in:
	a. primary position b. right gaze c. left gaze d.  they all appear equal
2.	The most likely cause for the head posture assumed by this child is:
	a. to avoid diplopia b. because this position is more comfortable c. poor vision in the right eye d.  to avoid the visual discomfort caused by past pointing
3.	The  cause of this exodeviation is most likely:
	a. bilateral III nerve palsy b. response to optic atrophy in the right eye c. co-contraction of the lateral recti d.  not clear from the pictures shown

For answers to the above, click here: