Clinical observations in cyclodeviations.

Cyclodeviations differ from other strabismus forms in several aspects. Adaptive mechanisms other than suppression cause the patient to remain asymptomatic in spite of ophthalmoscopically demonstrable torsion of the globe around the sagittal axis. These mechanisms include cyclofusion and a monocular sensory adaptation causing the images seen by the paretic eye to appear vertically and horizontally aligned even though they do not fall on the vertical and horizontal anatomic-geometric retinal meridians. Pure excyclotropias, ie, those not associated with vertical deviations, respond well to anterior and lateral displacement of the anterior portion of the superior oblique tendon. The operation eliminated the cyclodeviation in four eyes (three patients); however, a partial recurrence was observed in one case.