• Courtesy of Edward L. Raab, MD
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    Pediatric Ophth/Strabismus

    Right inferior oblique muscle palsy. There is a small left hypertropia in primary position that increases in left gaze and with head tilt to the left, the 3-step pattern consistent with this diagnosis. This patient had no abnormal neurologic findings. Note convergence in straight upgaze, an important point of differentiation from Brown syndrome.