Background: The vertical strabismus manifested by Abraham Lincoln has
been noted. This article reviews the historical findings and provides
a specific diagnosis. Materials: Previous reports of symptoms and hist
ory relating to Lincoln's left hypertropia were reviewed. A series of
photographs were reviewed. Lincoln's own description of his symptoms i
s provided. Results: Previous history indicates an intermittent left h
ypertropia. A family history of vertical strabismus was noted with reg
ard to Mr Lincoln's cousin. There also is a history of trauma to the l
eft frontal area and life-mask evidence of fracture over the left eye,
The findings include a history of head tilt and diplopia, presumably
most readily in downgaze. Conclusion: Given the history and findings,
the diagnosis of left superior oblique paresis of either congenital or
traumatic origin seems appropriate.