PMC5892332_01
1, fixing left eye moderate RXT; 2, fixing right eye moderate LXT; 3, fixing right eye more LXT + slight hypotropia + left ptosis; 4, fixing right eye (slight adduction) LXT + slight left hypotropia + left ptosis; 5-7, fixing right eye further in left gaze significant left hypotropia and ptosis; 8, fixing right eye in abduction + left eye upshot.
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F1
While fixating with the right eye, the left eye showed moderate exotropia and as the right eye moved inwards towards left gaze, there was increasing left hypotropia and ptosis (Fig. 1). When the patient fixated with the right eye in right gaze, there was significant limitation of left adduction and upshoot of the left eye (Fig. 1).
1, fixing right eye left XT + ptosis; 2, occluding RE; 3-5, fixing left eye RXT + slight right hpotropia + slight right ptosis; 6, 7, fixing left eye in primary position + significant right hypotropia; 8, fixing left eye in attempted dextrodepression + significant right hypotropia.
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F2
Similarly, when the patient was fixating with the left eye, the right eye showed moderate exotropia and on attempted left adduction the right eye showed exotropia and significant hypotropia and ptosis (Fig. 2).
Ocular rotations in different gaze positions.
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F3
The ocular alignment varied widely with change of fixation and with any slight change in the direction of gaze (Fig. 3).