Lower lid retraction in traumatic disinsertion of the inferior rectus muscle

Traumatic disinsertion of an inferior rectus muscle in a 25-year-old man was diagnosed preoperatively by an associated lower lid retraction. This finding is significant in differentiating a traumatic disinsertion of the inferior rectus from an inferior rectus palsy secondary to an orbital floor fracture. Associated findings include ipsilateral hypertropia, impaired depression of the affected eye in abduction, the formation of a sulcus in the lower lid on attempted downgaze, negative forced duction testing, and positive forced muscle generation.