He experienced diplopia upon right lateral gaze, with reduced abduction and
supraduction. There was reduced sensation in the distribution of the opthalmic (V1) and maxillary (V2) branches of the trigeminal nerve.
* Ductions: An examination of the muscles of a single eye (monocular movements): adduction, abduction,
supraduction, infraduction, incycloduction, excycloduction (12).
The right eye was deviated to the right with severe limitation in
supraduction, infraduction, and adduction consistent with pupil-sparing third-cranial nerve (CN III) palsy.
[sup][6] The flap created by the proposed procedure connects the upper fornix and the lower lid margin and transmits the
supraduction force from the upper fornix into an upward force to raise the lower lid.
The
supraduction of the left eye was still insufficient but was improved, and the effects were stable at the 6-month follow-up.
* limited
supraduction due to weakness of superior rectus and inferior oblique muscles
However, further exam showed mild proptosis with Hertel exophthalmometric measures as: 20 OS, 24 OD, and restricted supraduction, adduction OD in extraocular eye movements.
The final neurological examination revealed mild supraduction and restriction of adduction OD as well as improved proptosis (Hertel exophthalmometric exam: 20 OS, 22 OD).
The term 'elevation' to describe an upward rotation and 'depression' for a downward rotation tend to be used in favour of the more logical
supraduction and infraduction.
It is caused by conversion of lateral rectus muscle function from abduction to infraduction leading to impaired abduction and
supraduction.
