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This 16-year-old patient had resection of the right medial rectus and recession of the right lateral rectus for intermittent exotropia.  Immediately after surgery he appeared as shown above.  This is a new finding.  He had no limitation of upgaze before the surgery.

1.	The findings in this patient suggest a diagnosis of:
	a. acquired Brown syndrome b. Duane syndrome c. double elevator palsy d.  blow out fracture
2.	A likely cause of this limitation of upgaze after surgery is:
	a. superior rectus palsy b. trochlear dislocation c. inferior oblique inclusion d.  acute trochleitis
3.	The most effective management of this condition is:
	a. nothing now; just wait and observe b. oral steroids c. base-up prism right lens d.  surgery

For answers to the above, click here on or after March 8, 2005.