A 3-year-old healthy girl was brought to a clinic for the evaluation of misaligned eyes, which were evident when she looked up or to the right. Her mother reported no abnormality when the child looked straight ahead. Her medical and ocular history was unremarkable.
Ophthalmologic examination Visual acuity: 20/20 in both eyes without correction (HOTV matching method) Mild hyperopia Normal bilateral pupillary responses Normal intraocular pressure Normal fundus examination Titmus testing The patient could see the fly She could neither see the three animals nor the nine circles Motility examination When the patient was viewed from a close and long-distance, the primary gaze of the patient was orthotropic ( Fig. 1 ) Inability to elevate the left eye while looking up and to the right side ( Fig. 2 ) Rest of the version testing results were normal Slight right face turn What is the probable…
