Double elevator palsy (DEP) currently known as Monocular Elevation Deficit is a rare condition characterized by restricted elevation of one eye in all positions of up gaze. Clinically it presents as a unilateral restriction of superior rectus (SR) and inferior oblique (IO). We present a case report of DEP in 3 year old boy who presented with sudden onset of DEP in right eye in our OPD. Very little information on acquired causes of DEP is available. Diagnosis, differential diagnosis and management are discussed and then the literature is reviewed.
KEYWORDS: DOUBLE ELEVATOR PALSY (DEP), MONOCULAR ELEVATION DEFICIT (MED), UPGAZE PALSY.INTRODUCTION: Double elevator palsy (DEP) is a rare condition which was first described by White in 1942 and later by Dunlap. 1 In DEP there is apparent paralysis of the elevators of one eye, the superior rectus and inferior oblique resulting in restricted elevation. DEP is actually a misnomer because true paralysis of the elevator muscles is seen only one-fourth of cases and mostly only one of the elevator muscles may be involved in certain cases. Hence DEP is better known as Monocular Elevation Deficit (MED) 2 .
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