DR. GARGI BHALLA

DR. ANSHU SHARMA, DR. MARISHA BISHNOI, DR. PRIYANKA MOHANBABU CHATURVEDI

Abstract

Double elevator palsy also known as the monocular elevation deficiency (MED) is the limitation of elevation due to the unilateral restriction of elevation and weakness of one or both elevator muscles, the superior rectus or inferior oblique could be congenital or acquired. Congenital cases of MED occur sporadically, causes include supranuclear palsy, primary superior rectus paresis and primary inferior rectus restriction. We hereby report that a 6 year old male presented with complaints of drooping of right eyelid since birth and diminision of vision since 1year. On examination, his best corrected visual acuity in right eye 6/18 and in left eye 6/6, mild chin elevation present with restriction of extra ocular movements in up gaze and abduction, severe ptosis, weak bells phenomenon in right eye. Squint work up and refraction was done. Patient requiring surgical management was counselled about possibility of multiple surgeries according to the clinical assessment.