What is the difference between infantile bilateral superior oblique muscle palsy and bilateral superior rectus muscle palsy?

Patient's question:

What is the difference between infantile bilateral superior oblique muscle palsy and bilateral superior rectus muscle palsy? Thank you!

Doctor's answer:

Unilateral superior oblique and inferior oblique muscle palsy refers to the simultaneous paralysis of the superior oblique muscle and inferior oblique muscle in one eye. Clinically, it presents with esotropia in the affected eye, often accompanied by horizontal strabismus and ptosis of the upper eyelid. This type of ptosis is usually false or mixed, and it is prone to misdiagnosis.

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