No movement can be made past the midline, even with forced ductions. Fibrotic medial rectus results in an eso deviation, lateral rectus in an exo deviation, and inferior rectus in hypotropia. Return to list of strabismus disorders Brown's Syndrome Brown's syndrome, or superior oblique tendon sheath syndrome, describes an inability to elevate the adducted eye above the horizontal plane. Restriction decreases as eye moves laterally, but does persist. Palpebral fissure widening may accompany adduction with elevation restriction.
Surgery yields poor results.
Return to list of strabismus disorders Double Elevator Palsy Double elevator palsy is rare and is due to combined weakness of contraction of both inferior oblique and superior rectus muscles in the same eye. There may be a complete inhibition of movement in upper field of gaze. Treatment involves transposition of the insertions of the medial rectus and lateral rectus to the insertion of the superior rectus. Parinaud's Disease Parinaud's disease is a paralysis of vertical movement, possibly due to lesions in the brain centers directing this action. The most common cause is a tumor of the pineal gland.