The test revealed that the ptosis increased after prolonged
upgaze and improved after the ice test which supported the preliminary diagnosis (Figure 3).
The patient described slight diplopia on
upgaze. Hess screen test showed normal SO function with -1 hypofunction in the IO muscles.
This is a vertical palsy, mostly affecting
upgaze, with pseudo Argyll-Robertson pupil and convergence retraction nystagmus.
Extreme
upgaze produces the greatest IOP elevation of all eccentric eye positions (mean: 6.8 mmHg) [9].
Benign paroxysmal tonic
upgaze of childhood in a hypotonic infant with Beckwith-Wiedemann syndrome.
A 40-year-old Hungarian woman suddenly noticed
upgaze diplopia and right cheek compression when she woke up in the morning.
Diabetic third nerve palsy presents with abrupt onset retro-orbital pain, followed by double vision, unilateral ptosis, restriction of medial and
upgaze and sparing of the pupil.
Monocular elevation deficiency (MED) is classified as three subtypes: 1) restrictive form, with features including positive forced duction test (FDT) for elevation, normal elevation forced generation test (FGT), and elevation saccadic velocity, often an extra or deeper lower eyelid fold on attempted
upgaze and poor or absent Bell phenomenon; 2) paretic form with elevator muscle weakness, with features including free FDT, reduced elevation FGT and saccadic velocity, in which the Bell phenomenon is often preserved; and 3) a combination form, with features including positive FDT for elevation and reduced FGT and saccadic velocity for elevation.
Her cranial nerves were notable for impaired
upgaze, but otherwise intact EOMs with slow tracking but no abnormal saccades and no nystagmus.
Patients who had apparent restriction in ocular motility especially upon
upgaze, pain on looking upward or apparent enophthalmous, surgery was carried out within 24 hours after trauma in order to alleviate any ischemic tethering the fracture site would impose on the orbital content.
Paroxysmal tonic
upgaze of childhood: effect of age-of-onset on prognosis.