Abstract
A 20-year-old lady presented with drooping of left upper eyelid since childhood. After detailed examination she was diagnosed to have congenital monocular elevation deficiency and exotropia in the left eye. Sequential surgical correction procedures were performed to treat her left eye condition i.e., first surgery to correct exotropia (recession and resection of the horizontal recti), second surgery to correct hypotropia (recession and resection of vertical recti) without Knapp’s or modified Knapp’s proceadure. Left eye was looking straight in primary position; however, there was hypertropia in the right eye. Third surgery was done to correct hypertropia in the right eye (recession and resection of vertical recti) following which both eyes were straight in primary position. Even though the patient has undergone surgery three times, she was very happy with good cosmetic results.
Highlights
Monocular elevation deficiency (MED) is defined as limitation of elevation of the affected eye in primary gauze as well as adduction, abduction positions
In a case of MED when the person fixes with the normal eye, the affected eye shows hypotropia and pseudoptosis
We report a young lady with congenital monocular elevation deficiency with exotropia with good cosmetic results after sequential surgical procedures
Summary
Monocular elevation deficiency (MED) is defined as limitation of elevation of the affected eye in primary gauze as well as adduction, abduction positions. Common presentation will be hypotropia with drooping of upper eyelid. This was thought to be due to paresis of the two eye elevators, the superior rectus and inferior oblique (two elevators of the eye and termed as double elevator palsy) [1]. In a case of MED when the person fixes with the normal eye, the affected eye shows hypotropia and pseudoptosis. The surgical management of congenital MED with exotropia as performed in this case is not available in the literature. We report a young lady with congenital monocular elevation deficiency with exotropia with good cosmetic results after sequential surgical procedures
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