Lateral Rectus Superior Compartment Palsy
Lateral rectus palsy with hypotropia constitutes a portion of sixth nerve palsy cases in which only the superior compartment of the lateral rectus is palsied. We present such a case in a 10-year-old girl who presented with a peculiar appearing right esotropia and hypotropia due to acquired lateral rectus palsy along with apparent ipsilateral superior rectus underaction. Neuroimaging confirmed atrophy of the superior part of lateral rectus as compared to the inferior half. Augmented superior rectus transposition to the lateral rectus along with adjustable bimedial recessions and bilateral inferior oblique myectomies were done to restore her cosmetic appearance.