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Marc Dinkin, MD
August 2014, Volume 20, Issue 4, Neuro-ophthalmology;
This video of the same
patient as in Supplemental Digital Content 8-1
shows an exotropia (reflective of left medial
rectus weakness) and a left hypotropia (reflective
of left superior rectus and inferior oblique
weakness). Notice how the movements of the
right eye are greater than the left eye during the
test, even though it is not the paretic eye; the left
eye is unable to move because of paresis. The
deviation of the right eye (there is both an
exotropia and hypertropia) is an example of a
secondary deviation and results from the Hering
law of equal innervation, which states that an
equal force is provided to each eye.
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