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   Table of Contents      
ARTICLES
Year : 1978  |  Volume : 26  |  Issue : 1  |  Page : 47-48

Paradoxical lid movement


Department of Ophthalmology, M.P. Shah Medical College & Irwin Group of Hospitals, Jamnagar, Gujarat, India

Correspondence Address:
Meena Kulkarni
Department of Ophthalmology, M.P. Shah Medical College & Irwin Group of Hospitals, Jamnagar, Gujarat
India
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Source of Support: None, Conflict of Interest: None


PMID: 711278

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How to cite this article:
Kulkarni M, Char J N, Vachhrajani M V, Matalia P D, Shah N T, Joshi M B. Paradoxical lid movement. Indian J Ophthalmol 1978;26:47-8

How to cite this URL:
Kulkarni M, Char J N, Vachhrajani M V, Matalia P D, Shah N T, Joshi M B. Paradoxical lid movement. Indian J Ophthalmol [serial online] 1978 [cited 2019 Dec 10];26:47-8. Available from: http://www.ijo.in/text.asp?1978/26/1/47/31458

The paradoxical movements of the upper eye lid constitute a rare type of congenital an­omaly noticed usually in an association with movements of other extraocular muscles (medial, lateral or inferior rectus) or with the muscles of mastication. They are involuntary in nature presumably due to the major portion of the innervation of the extrinsic muscles involved terminating in the levator. Elevation of the upper lid on downward movement of eyes synkinesis that resembles the pseudo Graefe phenomenon wherein the action of the levator is linked with the inferior rectus. Its hereditary transmission is noted by various authors[1]. This anomaly w;is noticed along with congenital ptosis.


  Case report Top


Kum. S. 16 year old Hindu female reported to eye O.P.D. with the complaint of drooping of right upper eyelid since birth. She had a normal birth. There was no history of trauma or debilitating illness in childhood. Neither of the family members had such a deformity.

On examination, visual acuity in both eyes was 6/6. Anterior segment and fundus, were clinically normal. Right upper lid showed ptosis covering the cornea from 10 O'Clock meridian to 2 O'clock. [Figure - 1]. It was marked in primary position and during upward gaze. Version movements were normal with no change in palpebral fissure [Figure - 3],[Figure - 2]. On downward gaze, the right upper lid failed to follow the movement of the globe and showed retraction [Figure - 4]. Rest of the eye movements were normal. Jaw-winking phenomenon was absent.


  Comments Top


The case reported is of a rare congenital anomaly of paradoxical innervation wherein the action of the levator is linked with that of inferior rectus.

 
  References Top

1.
Duke Elder, S. 19(4, Sys. of Ophthal., IV, 900, Henry Kinipton London.  Back to cited text no. 1
    


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]



 

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