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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:
	c -- This is a "V" pattern characterized by aligned eyes in upgaze and a large angle esotropia in downgaze. The chin down, eyes up position is assumed in order to avoid diplopia in downgaze and to achieve fusion in upgaze.
2.	This condition can be associated with:
	d -- This chin down position with "V" pattern can be seen in cases with inferior oblique overaction, pulley displacement, and at least the chin down eyes up position in cases with nystagmus and null point in up gaze.
3.	Treatment of this condition would most likely be:
	a -- This "V" pattern can be best treated with surgery done for the specific cause.  This could include alone or in combintion: weakening of overacting inferior oblique muscles, downshift of the medial rectus muscles with or without recession, and recession of the superior rectus muscles and resection of the inferior rectus muscles (to shift a null point).

See Strabismus Minute Vol. 1, No. 8  "Anomalous Head Posture and Strabismus"