DISSOCIATED EYE-MOVEMENTS IN CRANIOSYNOSTOSIS - A HYPOTHESIS REVIVED

A characteristic pattern of dissociated eye movements was observed in a large proportion of our patients with a variety of craniosynostosis syndromes. These anomialies simulate overaction of the inferior obliqu e and underaction of the superior oblique muscles which, however, cann ot fully explain the abnormalities. In a number of cases, excyclorotat ion of the muscle cone was observed, with the upper pole of the eye ti lted away from the midline. It is postulated that such excyclorotation of the eyes will lead to dissociated eye movements which can be expla ined on physiological grounds according to Hering's law. This paper pr esents a review of our patients and evidence to support this hypothesi s.