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Hypertropia may be either congenital or acquired, and misalignment is due to imbalance in extraocular muscle function. The superior rectus, inferior rectus, superior oblique, and inferior oblique muscles affect the vertical movement of the eyes.
Skew deviation is an unusual ocular deviation , wherein the eyes move upward (hypertropia) in opposite directions. Skew deviation is caused by abnormal prenuclear vestibular input to the ocular motor nuclei, most commonly due to brainstem or cerebellar stroke. Other causes include multiple sclerosis and head trauma.
Fixation disparity is a tendency of the eyes to drift in the direction of the heterophoria.While the heterophoria refers to a fusion-free vergence state, the fixation disparity refers to a small misalignment of the visual axes when both eyes are open in an observer with normal fusion and binocular vision. [1]
The prism cover test (PCT) is an objective measurement and the gold standard in measuring strabismus, i.e. ocular misalignment, or a deviation of the eye. [1] It is used by ophthalmologists, orthoptists, and optometrists in order to measure the vertical and horizontal deviation and includes both manifest and latent components. [1]
Congenital fourth nerve palsy is a condition present at birth characterized by a vertical misalignment of the eyes due to a weakness or paralysis of the superior oblique muscle. Other names for fourth nerve palsy include superior oblique palsy and trochlear nerve palsy. [1]
When the misalignment of the eyes is large and obvious, the strabismus is called large-angle, referring to the angle of deviation between the lines of sight of the eyes. Less severe eye turns are called small-angle strabismus. The degree of strabismus can vary based on whether the person is viewing a distant or near target.
Method for measuring vertical deviations: 1. The Maddox Rod is held in front of the patient's right eye with the cylinders vertical, making the red line horizontal. 2. The patient is then asked whether the white light is superimposed on the red line or if it appears above or below the red line.
Heterophoria is the misalignment of the visual axis such that one or both eyes are not properly fixated to an object of interest. When the visual axis is misaligned in such a way, it is corrected by the fusional vergence system.