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CASE REPORT
Year : 2017  |  Volume : 4  |  Issue : 1  |  Page : 39-40

Double elevator palsy with hypotropia, exotropia, and ptosis with dissociated vertical deviation in other eye managed with knapp's procedure


1 Department of Ophthalmology, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
2 Department of Ophthalmology, Baroda Medical College, Vadodara, Gujarat, India

Correspondence Address:
Akash Pankaj Shah
27-A Shrinagar Society, Productivity Road, Akota, Vadodara - 390 020, Gujarat
India
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DOI: 10.4103/1858-6538.205800

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The aim of this study is to report a case of double elevator palsy (DEP) managed with Knapp's procedure. An 18-year-old female presented to us with a complaint of drooping of the right eyelid since childhood. Best-corrected visual acuity was 6/12 in right eye and 6/6 in left eye. Elevation in right eye was absent. Her right eye showed 14–16 prism diopter (PD) hypotropia with 10 PD exotropia, and the left eye showed dissociated vertical deviation (DVD). Her palpebral fissure height was 6 mm in right eye and 9 mm in left eye with marginal reflex distance-1, 1 and 4 mm, respectively. Levator palpebrae superioris action was 7 mm in right eye and 14 mm in left eye. Bell's phenomenon was absent in right eye. Diagnosis of right eye DEP with ptosis and exotropia on left eye DVD was made. Knapp procedure in right eye was performed with postoperative orthophoria in primary position. Knapp's procedure is the surgery of choice in a case of DEP.


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