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Revista Cubana de Oftalmología

Print version ISSN 0864-2176


HERNANDEZ SANTOS, Lourdes Rita et al. Presentation of two cases of dissociated vertical deviation related to A-pattern. Rev Cubana Oftalmol [online]. 2013, vol.26, suppl.1, pp.694-701. ISSN 0864-2176.

The dissociated vertical deviation is a bilateral, asymmetric phenomenon, in which an elevation, abduction and excyclotorsion movement occurs during the monocular occlusion that is generally more evident in the non-fixing eye. When the vertical deviation is associated to A-patterns and overreaction of both superior oblique muscles, then this entitiy is known as triad that can be primary or secondary to esotropia surgery. In planning one surgery for these cases, it is always necessary to take into account the symmetry and the non-commitance grade. The surgical options will depend on whether it is a primary (not prior surgery) triad or a secondary triad. Here are two patients with secondary triad who, despite their similar diagnosis, the surgical plan for both were different. One patient underwent about 7 mm recession of both lateral rectus muscles with the insertion displacement downwards (half of the insertion) and myectomy in the right inferior oblique muscle whereas asymmetric recession of both superior rectus muscles, 6 mm for the right eye and 4 mm for the left eye, was performed in the other patient.

Keywords : dissociated vertical deviation; triad; patterns.

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