Abstract
Treating vertical squints especially large-angle hypertropia caused by inferior rectus palsy is a challenge. Superior rectus recession in presence of positive forced duction tests is the first step in surgical management. Following this, full tendon transposition of horizontal recti inferiorly (Inverse Knapp's procedure) is the standard procedure of choice. Modified Nishida's procedure has been described to treat vertical deviations like MED and inferior rectus aplasia. We describe a case of large-angle hypertropia treated by Modified Nishida's procedure.
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