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[Skew deviation]

F X Borruat1, F Gianoli, P Maeder

  • 1Hôpital Ophtalmique Jules Gonin, Lausanne. fborruat@hola.hospvd.ch

Klinische Monatsblatter Fur Augenheilkunde
|July 25, 1998
PubMed
Summary
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Skew deviation, a vertical eye misalignment, is often underdiagnosed but treatable. Most patients recover within months, with surgery only recommended after a year.

Area of Science:

  • Neuro-ophthalmology
  • Neurology

Context:

  • Skew deviation is a vertical ocular misalignment of prenuclear origin.
  • It is likely underdiagnosed, and its natural history is not well-documented.

Purpose:

  • To describe the clinical presentations, etiologies, and follow-up of skew deviation.
  • To highlight the importance of considering skew deviation in cases of unexplained vertical diplopia.

Summary:

  • A retrospective study of 29 patients revealed cerebrovascular accidents as the most common cause (12/29), often affecting the mesencephalon (9/29).
  • Vertical diplopia was consistently accompanied by other neuro-ophthalmologic abnormalities.
  • Approximately 70% of patients recovered within a median of 7.5 months, with interventions like prisms or monocular occlusion used for persistent symptoms.

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Impact:

  • Skew deviation is more common than previously thought, accounting for 10% of diplopia referrals.
  • Early diagnosis and appropriate management, including delayed surgical intervention, improve patient outcomes.
  • This study provides valuable insights into the prognosis and management of skew deviation.