hypertropia

In hypertropia the light lands on the inferior aspect of the cornea.

There are also vertical tropias (hypertropia and hypotropia) and cyclotropias.

Hypertropia may be either congenital or acquired, and misalignment is due to imbalance in extraocular muscle function.

Surgical correction of the hypertropia is desired to achieve binocularity, manage diplopia and/or correct the cosmetic defect.

Steps to achieve the same depend on mechanism of the hypertropia and identification of the offending muscles causing the misalignment.

Cyclotorsional deviation of the eyes (rotation around the visual axis), particularly when the root cause is an oblique muscle paresis causing the hypertropia.

Skew deviation is an unusual ocular deviation (strabismus), wherein the eyes move upward (hypertropia), but in opposite directions.

Dissociated Vertical Deviation is a special type of hypertropia leading to slow upward drift of one or rarely both eyes, usually when the patient is inattentive.

When this muscle's function is diminished due to a fourth cranial nerve (CN IV) palsy, the affected eye will extort, deviate upward (hypertropia), and, to a smaller extent, drift inward.

This condition includes horizontal tropias exotropia and esotropia which are outward and inward horizontal deviations and hypertropia and hypotropia which are when one eye is set higher or lower than the other eye.

Sudden onset hypertropia in a middle aged or elderly adult may be due to compression of the trochlear nerve and mass effect from a tumor, requiring urgent brain imaging using MRI to localise any space occupying lesion.