Bilateral inferior insertion of lateral rectus muscles associated with schizencephaly

A 5-year-old boy with a large V-pattern exotropia is described. He has a ba ckground of congenital left hemiparesis associated with schizencephaly. At the time of surgery the lateral recti were found to be abnormally inferiorl y positioned. Accordingly, both lateral rectus muscles were recessed 6.5 mm and supraplaced. A V-pattern exotropia persisted postoperatively with clin ical overaction of the inferior obliques. To our knowledge this is the firs t known case of extraocular muscle abnormalities associated with schizencep haly.