Management of vertical ocular deviations secondary to restrictive conditions

Abstract

Background and purpose: Management of vertical strabismus secondary to restrictive conditions can be challenging for both the patient and practitioner. The purpose of this paper is to identify both common and uncommon causes of vertical restrictive strabismus, to discuss the evaluation of these conditions, and to briefly review the etiology and recommendations for surgical management.

Method: Current literature was reviewed as well as the surgical techniques that have been found to be most useful from experience over the past twenty years of practice.

Conclusion: Surgical realignment and elimination of diplopia is both challenging and problematic. Surgery should be designed to relieve restriction, with attention to identifying and managing incomitance. Furthermore, it is important to establish realistic goals with patients.