Vertical deviations

Causes

• Oblique muscle abnormalities (palsies/overaction)

  • Inferior oblique overaction
  • DVD

• Mechanical (normal saccadic velocity)

  • Congenital fibrosis of the extraocular muscles (CFEOM)
  • Thyroid eye disease
  • Myasthenia gravis
  • Trauma/orbital fracture

• Neurological (slowed saccades)

  • Third nerve palsy
  • Fourth nerve palsy (superior oblique palsy)
  • Double…