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This 10-year-old boy according to his parents watches television and reads with his chin in an exaggerated downward position.  Visual acuity is 20/20 in each eye, there is no nystagmus, refraction is plano in each eye, and the boy has had no prior eye treatment and is in good health.  He is able to fuse the stereo fly and the top row of animals on the Titmus chart (400 sec arc disparity).  He notes double vision when he looks downward.  The boy himself has no ocular or other complaints.

1.	This boy's condition would be most accurately described as:
	a. Lambda pattern b. “A” pattern c. “V” pattern d.  alphabetic pattern
2.	This condition can be associated with:
	a. overaction of the inferior oblique muscles b. upward displacement of the medial rectus muscle pulleys c. nystagmus with a null point in upgaze d.  all of the above
3.	Treatment of this condition would most likely be:
	a. surgical b. with appropriate prisms c. carried out with eye exercises d.  accomplished by the use of pharmacologic agents such as Botox

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