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December 1980

Saccades With Limited Downward Gaze

Author Affiliations

From the Department of Ophthalmology, University of Rochester (New York) School of Medicine and Dentistry.

Arch Ophthalmol. 1980;98(12):2204-2205. doi:10.1001/archopht.1980.01020041056011

• Fourteen patients with monocular limitation of downward gaze had vertical saccadic velocity measurements. Patients with orbital floor fracture and endocrine ophthalmopathy were excluded from the group. In four cases (29%), the difference between upward and downward saccadic velocities was 20% or less. These patients were not thought to have any evidence of inferior rectus muscle paresis. In ten cases (71%), the difference between upward and downward saccades varied between 46% to 275% (average, 115%), upward saccades being more rapid in each case. These cases were all believed to have moderate to great inferior rectus muscle palsy. In one subject with a lidocaine hydrochloride-induced inferior rectus muscle palsy, upward saccades were 135% faster than downward saccades. These findings were compared with those in patients with monocular limitation of elevation, and the surgical management was reviewed.