Inherited levator-medial rectus synkinesis
M. P. Pang, P. H. Zweifach and J. Goodwin
We examined two sisters with lid retraction on adduction, the classic sign
of levator-oculomotor synkinesis. In both women, the left eye was involved.
No history of trauma or ocular surgery or complaints of diplopia were
elicited, and both had good visual acuity and full ocular motility. Each
exhibited 2 mm of left upper lid elevation on adduction and 4 to 6 mm of
lid elevation on adduction with depression. In one of the sisters, 1 mm of
ptosis was present in straight ahead gaze in the involved eye, which
increased to almost 2 mm on abduction, but full levator function was
observed. Four other family members in three consecutive generations were
similarly affected, suggesting an autosomal-dominant mode of inheritance.
To our knowledge, this type of isolated levator-oculomotor synkinesis has
not been reported previously on a congenital and inherited basis.
