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This 5-year-old girl was presented for examination appearing as shown in the pictures. She appeared to have her chin slightly down. Vision was 6/6 in each eye without correction. Refraction was OD +1.00 and OS +1.25; no glasses were worn. The remainder of the eye examination was within normal limits except for ocular motility which is shown in the pictures.

1.	This girl demonstrates a:
	a. “A” pattern b. “V” pattern c. Lambda pattern d. “X” pattern e. no pattern
2.	Based on observation of these pictures in the diagnostic positions, with head tilt, and occlusion, the examiner would consider the following:
	a. The patient has strabismus sursoadductorius (over elevation in adduction). b. The superior oblique tendons could be lax. c. The inferior obliques are overacting. d. There is an ET in down gaze and XT in upgaze. e. all of the above
3.	Treatment of this condition would most likely be:
	a. surgery b. prism c. orthoptics d. a trial of glasses e. none of the above

For answers to the above, click here on or after March 22, 2011.