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Alternating hypotropia

MedGen UID:: 1638862
•Concept ID:: C4703710
•: Disease or Syndrome

HPO:	HP:0500078

Definition

A type of vertical tropia in which, when one eye is fixing, the other eye is deviated downwards. [from HPO]

Term Hierarchy

GTR
MeSH

CClinical test, RResearch test, OOMIM, GGeneReviews, VClinVar

CROGVAlternating hypotropia

Abnormal eye physiology
- Abnormality of eye movement
  - Abnormal conjugate eye movement
    - Strabismus
      - Heterotropia
        Hypotropia
        Alternating hypotropia

Recent clinical studies

Etiology

Strabismus in chronic progressive external ophthalmoplegia.

Kim JY, Yang HK, Kim N, Kim MJ, Cho SI, Seong MW, Park SS, Hwang JM
Acta Ophthalmol 2021 Mar;99(2):e274-e280. Epub 2020 Nov 15 doi: 10.1111/aos.14558. PMID: 33191655

Retro-equatorial inferior oblique myopexy for treatment of inferior oblique overaction.

Kasem M, Metwally H, El-Adawy IT, Abdelhameed AG
Graefes Arch Clin Exp Ophthalmol 2020 Sep;258(9):1991-1997. Epub 2020 May 27 doi: 10.1007/s00417-020-04742-4. PMID: 32462341

Surgical Management in Type 1 Monocular Elevation Deficiency.

Ocak OB, Inal A, Aygit ED, Celik S, Ocak SY, Karabulut GO, Gokyigit B
J Pediatr Ophthalmol Strabismus 2018 Nov 19;55(6):369-374. Epub 2018 Jul 27 doi: 10.3928/01913913-20180620-04. PMID: 30074607

To assess the efficacy of vertical muscle surgery for management of hypotropia in monocular elevation deficiency type II.

Kamlesh, Dhiman S, Thacker P, Karothiya B, Goel Y, Rastogi A, Chaudhary R
Int Ophthalmol 2017 Aug;37(4):1009-1016. Epub 2016 Oct 3 doi: 10.1007/s10792-016-0365-6. PMID: 27699607

Surgery for Supranuclear Monocular Elevation Deficiency.

Struck MC, Larson JC
Strabismus 2015;23(4):176-81. doi: 10.3109/09273972.2015.1099710. PMID: 26669423

See all (18)

Diagnosis

Comparison of head tilt test between sagging eye syndrome and acquired unilateral trochlear nerve palsy.

Yamadera K, Kimura A, Okita Y, Mochizuki Y, Gomi F
Graefes Arch Clin Exp Ophthalmol 2024 May;262(5):1641-1646. Epub 2023 Dec 23 doi: 10.1007/s00417-023-06347-z. PMID: 38141057 Free PMC Article

Marcus-Gunn jaw winking syndrome: case series study and management algorithm.

Quaranta-Leoni FM, Quaranta-Leoni C, Di Marino M
Orbit 2024 Feb;43(1):33-40. Epub 2023 Mar 1 doi: 10.1080/01676830.2023.2182330. PMID: 36855996

Surgical Management in Type 1 Monocular Elevation Deficiency.

Ocak OB, Inal A, Aygit ED, Celik S, Ocak SY, Karabulut GO, Gokyigit B
J Pediatr Ophthalmol Strabismus 2018 Nov 19;55(6):369-374. Epub 2018 Jul 27 doi: 10.3928/01913913-20180620-04. PMID: 30074607

A cyclic vertical deviation with dysthyroid ophthalmopathy: a case report.

Paik JS, Yang SW, Park SH
BMC Ophthalmol 2016 Jul 22;16:119. doi: 10.1186/s12886-016-0300-7. PMID: 27449491 Free PMC Article

Cyclic (alternate day) vertical deviation--possible forme fruste of ocular neuromyotonia.

Roper-Hall G, Cruz OA, Espinoza GM, Chung SM
J AAPOS 2013 Jun;17(3):248-52. doi: 10.1016/j.jaapos.2012.12.156. PMID: 23791405

See all (6)

Therapy

Retro-equatorial inferior oblique myopexy for treatment of inferior oblique overaction.

Kasem M, Metwally H, El-Adawy IT, Abdelhameed AG
Graefes Arch Clin Exp Ophthalmol 2020 Sep;258(9):1991-1997. Epub 2020 May 27 doi: 10.1007/s00417-020-04742-4. PMID: 32462341

Botulinum toxin injection for restrictive myopathy of thyroid-associated orbitopathy: success rate and predictive factors.

Akbari MR, Ameri A, Keshtkar Jaafari AR, Mirmohammadsadeghi A
J AAPOS 2016 Apr;20(2):126-130.e1. doi: 10.1016/j.jaapos.2016.01.007. PMID: 27079592

Cyclic (alternate day) vertical deviation--possible forme fruste of ocular neuromyotonia.

Roper-Hall G, Cruz OA, Espinoza GM, Chung SM
J AAPOS 2013 Jun;17(3):248-52. doi: 10.1016/j.jaapos.2012.12.156. PMID: 23791405

Temporary management of diplopia with botulinum toxin in multiple ocular motor cranial neuropathies.

Tejedor J, Díez L
Eur J Ophthalmol 2012 Nov-Dec;22(6):1042-4. Epub 2012 Sep 26 doi: 10.5301/ejo.5000202. PMID: 23097020

Acquired cyclic exotropia and hypotropia.

Murthy R, Hegde S
J AAPOS 2009 Jun;13(3):312-4. doi: 10.1016/j.jaapos.2009.01.008. PMID: 19541276

See all (5)

Prognosis

To assess the efficacy of vertical muscle surgery for management of hypotropia in monocular elevation deficiency type II.

Kamlesh, Dhiman S, Thacker P, Karothiya B, Goel Y, Rastogi A, Chaudhary R
Int Ophthalmol 2017 Aug;37(4):1009-1016. Epub 2016 Oct 3 doi: 10.1007/s10792-016-0365-6. PMID: 27699607

A cyclic vertical deviation with dysthyroid ophthalmopathy: a case report.

Paik JS, Yang SW, Park SH
BMC Ophthalmol 2016 Jul 22;16:119. doi: 10.1186/s12886-016-0300-7. PMID: 27449491 Free PMC Article

Botulinum toxin injection for restrictive myopathy of thyroid-associated orbitopathy: success rate and predictive factors.

Akbari MR, Ameri A, Keshtkar Jaafari AR, Mirmohammadsadeghi A
J AAPOS 2016 Apr;20(2):126-130.e1. doi: 10.1016/j.jaapos.2016.01.007. PMID: 27079592

Inferior rectus muscle recession as a treatment for vertical diplopia following cataract extraction.

Schild AM, Fricke J, Neugebauer A
Graefes Arch Clin Exp Ophthalmol 2013 Jan;251(1):189-94. Epub 2012 Mar 22 doi: 10.1007/s00417-012-1996-6. PMID: 22434212

Long-term outcome of patients with large overcorrection following surgery for exotropia.

Kim TW, Kim JH, Hwang JM
Ophthalmologica 2005 Jul-Aug;219(4):237-42. doi: 10.1159/000085734. PMID: 16088244

See all (8)

Clinical prediction guides

Strabismus and binocular diplopia due to advanced glaucomatous visual field loss.

Khanna CL, Holmes JM
J AAPOS 2017 Aug;21(4):263-267. Epub 2017 Jun 20 doi: 10.1016/j.jaapos.2017.06.009. PMID: 28642003

To assess the efficacy of vertical muscle surgery for management of hypotropia in monocular elevation deficiency type II.

Kamlesh, Dhiman S, Thacker P, Karothiya B, Goel Y, Rastogi A, Chaudhary R
Int Ophthalmol 2017 Aug;37(4):1009-1016. Epub 2016 Oct 3 doi: 10.1007/s10792-016-0365-6. PMID: 27699607

Botulinum toxin injection for restrictive myopathy of thyroid-associated orbitopathy: success rate and predictive factors.

Akbari MR, Ameri A, Keshtkar Jaafari AR, Mirmohammadsadeghi A
J AAPOS 2016 Apr;20(2):126-130.e1. doi: 10.1016/j.jaapos.2016.01.007. PMID: 27079592

A-pattern strabismus with overdepression in adduction: a special type of bilateral skew deviation?

Donahue SP, Itharat P
J AAPOS 2010 Feb;14(1):42-6. doi: 10.1016/j.jaapos.2009.11.009. PMID: 20227622

Super-maximum levator resection for severe unilateral congenital blepharoptosis.

Epstein GA, Putterman AM
Ophthalmic Surg 1984 Dec;15(12):971-9. PMID: 6395058

See all (5)