Cyclodeviation in acquired vertical strabismus
J. D. Trobe
The prevalence and pattern of cyclodeviation can differentiate among
superior oblique palsy, dysthyroid ophthalmopathy, myasthenia gravis, and
skew deviation. Excyclodeviation was detected in 30 of 33 patients with
superior oblique palsy, eight of 15 patients with dysthyroid
ophthalmopathy, three of six patients with nondysthyroid restrictive
ophthalmopathy, and one of 13 patients with myasthenia. No cyclodeviation
was found in cases of skew. Incyclodeviation was found in two patients with
dysthyroid ophthalmopathy, two with nondysthyroid restrictive
ophthalmopathy, and three with myasthenia. The amount of cyclodeviation did
not vary between head-tilt positions, but did vary between primary and
eccentric gaze positions, usually in the same direction as the amount of
hyperdeviation. The patient's awareness of the presence of cyclodeviation
varied with the degree of cyclodeviation, being 100% (4/4) for 15 degrees,
86% (12/14) for 10 degrees, and only 55% (11/21) for 5 degrees.
