The original term for this condition was double-elevator palsy , because it was felt to be due to a paralysis of both the ipsilateral superior rectus muscle (SR) and inferior oblique muscle (IO). We now recognize that it can be caused by inferior rectus muscle (IR) restriction in isolation [1, 2], supranuclear causes [3, 4], or paralysis of the SR without ipsilateral IO weakness [2, 3, 4]. There also can be IR restriction secondary to ipsilateral SR paresis. It is characterized by an inability to elevate above the midline in all horizontal gaze fields.
Aqueous drainage device Congenital fibrosis of the extraocular muscles Craniofacial syndromes Craniosynostosis Flap tears Forced duction Knapp procedure Marcaine myotoxicity Monocular elevation deficiency (MED) Monocular elevation deficiency Myasthenia gravis Orbital floor fracture Presbyopia Scleral buckling surgery Seton Sinus surgery Spring-back test Superior oblique myokymia Thyroid eye disease (TED)
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