EyeWiki:Featured article/August 15, 2019
Featured Article for August 15, 2019
Monocular Elevation Deficiency (MED) is the limitation of elevation of the affected eye from any position of gaze with normal ductions in all other gazes. MED is a frequent cause of hypotropia and can be associated with ptosis/pseudoptosis. Superior rectus palsy, inferior rectus restriction and supranuclear lesions have been found to be contributory to MED.
MED can be congenital or acquired . Congenital cases of MED occur sporadically. Congenital causes of MED include, supranuclear palsy, primary superior rectus (SR) paresis and primary inferior rectus(IR) restriction as in cases of congenital fibrosis of inferior rectus. Acquired MED is usually caused by trauma, cerebrovascular diseases like hypertension, thromboembolism, sarcoidosis, syphilis, and midbrain tumors like pineocytomas, acoustic neuromas and metastatic tumors affecting supranuclear pathways.