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This case report details a patient with intermittent double vision and left hypertropia, initially diagnosed as superior oblique palsy. The condition resolved after strabismus surgery, highlighting a rare eye movement disorder.

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Area of Science:

  • Ophthalmology
  • Neuro-ophthalmology
  • Strabismus

Background:

  • Superior oblique palsy can cause vertical strabismus and diplopia.
  • Rhythmic alternating fixation is a rare, poorly understood phenomenon.

Observation:

  • A patient presented with intermittent diplopia and left hypertropia.
  • Cover testing revealed conjugate rhythmic vertical eye movements in all gazes.
  • These movements were initially suspected to be rapid rhythmically alternating fixation.

Findings:

  • The observed conjugate rhythmic vertical eye movements are a key diagnostic feature.
  • The condition was associated with an apparent left superior oblique palsy.
  • Surgical intervention for strabismus led to the resolution of the rhythmic eye movements.

Implications:

  • This case expands the understanding of rare ocular motility disorders.
  • It suggests a potential link between strabismus and rhythmic alternating fixation.
  • Successful surgical management offers therapeutic insights for similar presentations.