A case of A-pattern esotropia with dissociated vertical deviation with bilateral congenital ptosis

Dissociated vertical deviation (DVD) is an enigmatic strabismus entity for which various theories of causation have been proposed. Commonly seen in association with infantile esotropia, it responds unpredictably to surgical intervention hence fuelling theories for a supranuclear center defect albeit at the midbrain level. Cases of DVD associated with A- pattern eso or exotropia and superior oblique overaction have been reported, although rarely. We report a case of bilateral congenital ptosis associated with this complex. Not reported earlier, we hope this case may help in better understanding of the obscure etiology of this symptom complex.