Hypotropic dissociated vertical deviation: a unique form of dissociated strabismus complex

Area of Science:

• Ophthalmology
• Strabismus Research
• Pediatric Ophthalmology

Background:

• Dissociated vertical deviation (DVD) is a rare strabismus disorder.
• Hypotropic DVD, a specific form, presents with downward ocular deviation.
• Understanding its clinical features is crucial for diagnosis and management.

Observation:

• This study reports four cases of hypotropic DVD and reviews existing literature.
• Data analyzed include age, visual acuity, laterality, deviation magnitude, and surgical interventions.
• A total of nine cases were collated for comprehensive analysis.

Findings:

• Hypotropic DVD is predominantly unilateral and diagnosed in adulthood (mean age 26.1 years).
• Associated factors include severe monocular vision deficits (except one case) and high myopia.
• Penetrating ocular injury was a cause in three cases; congenital strabismus was not observed.
• Surgical correction via inferior rectus muscle recession or recession-resection proved effective.

Implications:

• Hypotropic DVD should be recognized as a distinct entity within the dissociated strabismus spectrum.
• Early surgical intervention can improve outcomes for patients with this rare condition.
• Further research into the etiology and long-term management of hypotropic DVD is warranted.