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April 1990

Tonic Upgaze in Infancy

Author Affiliations

Chicago, Ill

Arch Ophthalmol. 1990;108(4):482-483. doi:10.1001/archopht.1990.01070060030014

Tonic, transient, vertical deviations in infancy in otherwise healthy neonates have been reported. Daroff and Hoyt1 reported one case of a patient with "tonic-(upward) oculogyric episodes." Ahn et al2 have recently reported three cases of tonic upgaze in infancy.

In our case, sustained tonic upgaze in an infant was associated with the development of amblyopia and strabismus requiring strabismus surgery. This case demonstrates the spontaneous resolution of tonic upgaze at 3½ months of age, associated with esotropia and the development of amblyopia. Patching therapy and strabismus surgery were required in this child, who currently appears orthophoric. Awareness of this entity can help avoid extensive neurologic evaluations in these children and should encourage close follow-up to watch for the possible development of amblyopia and strabismus.

Report of a Case.  —A 9-week-old male infant, the product of a normal delivery, with a birth weight of 3052 g was examined for the

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