Decompensated strabismus after laser in situ keratomileusis

We present a case of decompensated nerve IV palsy with vertical diplopia af ter bilateral laser in situ keratomileusis. As the patient was given monovi sion, we believe diplopia occurred with a decrease in vision int eye and in terruption of fusion. Although corrective spectacles to restore equal visio n at distance were prescribed, the patient needed a prism to eliminate her double vision. We suggest a careful cover/uncover test and versions assessm ent in ail candidates for refractive surgery who want monovision correction and a full ocular motility evaluation if there is any doubt about binocula r issues. (C) 1999 ASCRS and ESCRS.