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2004 Series : November 2, 2004
December 28, 2004  |  December 21, 2004  |  December 14, 2004  |  December 7, 2004  |  November 30, 2004  |  November 23, 2004  |  November 16, 2004  |  November 9, 2004  |  November 2, 2004  |  October 26, 2004  |  October 19, 2004  |  October 12, 2004  |  October 5, 2004  |  September 28, 2004  |  September 21, 2004  |  September 14, 2004  |  September 7, 2004  |  August 31, 2004  |  August 24, 2004  |  August 17, 2004  |  August 10, 2004  |  August 3, 2004  |  July 27, 2004  |  July 20, 2004  |  July 13, 2004  |  July 6, 2004  |  June 29, 2004  |  June 22, 2004  |  June 15, 2004  |  June 8, 2004  |  June 1, 2004  |  May 25, 2004  |  May 18, 2004  |  May 11, 2004  |  May 4, 2004  |  April 27, 2004  |  April 20, 2004  |  April 13, 2004  |  April 6, 2004  |  March 30, 2004  |  March 23, 2004  |  March 16, 2004  |  March 9, 2004  |  March 2, 2004  |  February 24, 2004  |  February 17, 2004  |  February 10, 2004  |  February 3, 2004  |  January 27, 2004  |  January 20, 2004

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This 3-year-old boy was noted by his mother to have a "funny" or unusual appearance to his eyes when looking up.  Visual acuity is 20/20 in each eye.  Cycloplegic refraction is +.50 in each eye.  He is able to fuse the stereo fly and 3 of 3 animals on the Titmus test.  Versions show limitation of elevation of the left eye in adduction and an exodeviation in upgaze.  The remainder of the eye examination is normal.  A slight left head tilt with chin elevation is present in casual seeing.

1.  The most likely diagnosis in this case is:   
 

a. inferior oblique palsy
b. Brown syndrome
c. double elevator palsy
d.  idiopathic torticollis

2.  The following is important in planning treatment for this patient   
 

a. age of the patient
b. the fusion status of the patient
c. primary position alignment
d.  all of the above

3.  If treatment were undertaken for this strabismus, the most likely choice would be  
 
a. left inferior oblique tuck
b. left superior rectus resection
c. left superior oblique weakening
d.  right superior rectus recession

For answers to the above, click here: