II. Definitions
- Skew Deviation (Vertical Ocular Misalignment, Vertical Strabismus, Vertical Heterotropia or Vertical Squint)
- Eye gaze deviation due to abnormal vestibular system inputs
- Typically from a posterior circulation Cerebrovascular Accident (Cerebellar CVA or Brainstem CVA)
- One eye may be directed forward normally, while the the other is directed either up (Hypertropia) or down (Hypotropia)
- Eye gaze deviation due to abnormal vestibular system inputs
III. Exam
- Perform as with Alternate Eye Cover Test (used to evaluate for horizontal Strabismus in children)
- Alternately cover one eye and then the other
- Observe for quick vertical gaze corrections (abnormal)
- Uncovered eye shifts to center from its abnormal, vertically displaced position
IV. Interpretation
- Abnormal skew test with quick vertical gaze corrections suggests a central cause (e.g. Brainstem CVA) of Acute Vestibular Syndrome
V. Associated Conditions
-
Head Tilt
- Often accompanies Skew Deviation
VI. References
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Related Studies
| Definition (NCI) | Vertical strabismus in which there is permanent upward deviation of the visual axis of one eye. |
| Concepts | Disease or Syndrome (T047) |
| MSH | D013285 |
| ICD9 | 378.31 |
| ICD10 | H50.2 |
| SnomedCT | 194109005, 40608009 |
| English | Hypertropias, Unspecified hypertropia, hypertropia (diagnosis), hypertropia, nonparalytic hypertropia, Unspecified hypertropia (disorder), Hypertropia (disorder), Hypertropia |
| Dutch | hypertropie, Hypertropie |
| Spanish | Hipertropía, Hipertropia, hipertropía no especificada (trastorno), hipertropía no especificada, hipertropía (trastorno), hipertropía |
| Japanese | 上斜視, ｼﾞｮｳｼｬｼ |
| Portuguese | Hipertropia |
| French | Hypertropie |
| German | Hypertropie, Fixation nach oben |
| Czech | Hypertropie, hypertropie |
| Hungarian | Hypertropia |
| Italian | Ipertropia |
| Norwegian | Hypertropi |
Ontology: Hypotropia (C0152208)
| Definition (NCI) | Vertical strabismus in which there is permanent downward deviation of the visual axis of one eye. |
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 378.32 |
| SnomedCT | 29491004 |
| English | hyop - Hypotropia, hypotropia (diagnosis), hypotropia, deviation downward eye, downward deviation of eyes, Downward deviation of eyes, Hypotropia, Hypotropia (disorder), Downward Ocular Deviation, Sunset Sign |
| Dutch | neerwaartse afwijking van de ogen, hypotropie |
| French | Hypotropie, Déviation du regard vers le bas |
| German | Hypotropie, nach unten gerichtete Abweichung der Augen |
| Italian | Ipotropia, Deviazione degli occhi verso il basso |
| Portuguese | Hipotropia, Desvio dos olhos para baixo |
| Spanish | Hipotropía, Desviación hacia abajo de los ojos, hipotropía (trastorno), hipotropía |
| Japanese | 下斜視, 眼の下方偏位, ｶｼｬｼ, ﾒﾉｶﾎｳﾍﾝｲ |
| Czech | Deviace očního bulbu dolů, Hypotropie |
| Hungarian | Hypotropia, Szemek lefele irányuló deviatiója |
Ontology: Manifest vertical squint (C0271364)
| Concepts | Disease or Syndrome (T047) |
| ICD10 | H50.2 |
| SnomedCT | 111530003, 246731005 |
| German | Strabismus verticalis |
| Korean | 수직 사시 |
| English | Manifest vertical squint (finding), Vertical strabismus, Manifest vertical squint, Manifest vertical squint (disorder), heterotropia; vertical, strabismus; vertical, vertical; heterotropia, vertical; strabismus, Vertical heterotropia, NOS, Vertical heterotropia |
| Dutch | heterotropie; verticaal, strabismus; verticaal, verticaal; heterotropie, verticaal; strabismus, Verticaal strabismus |
| Spanish | estrabismo vertical, heterotropía vertical (trastorno), heterotropía vertical |
Ontology: Skew Deviation (C0271381)
| Concepts | Finding (T033) |
| MSH | D015835 |
| SnomedCT | 40631009 |
| Portuguese | Desvio Oblíquo |
| Spanish | Desviación Oblicua, desviación oblicua (trastorno), desviación oblicua |
| French | Phénomène de Hertwig-Magendie, Syndrome de Hertwig-Magendie, Disjonction des mouvements du regard, Stéréodéviation |
| German | Magendie-Hertwieg-Schielstellung |
| English | skew deviation (physical finding), skew deviation, skew deviation was seen, Deviation, Skew, Deviations, Skew, Skew Deviations, Skew deviation, Skew deviation (disorder), deviation; skew deviation, Skew Deviation |
| Czech | šikmá deviace bulbů |
| Norwegian | Vertikal blikkdeviasjon |
| Italian | Deviazione obliqua |
| Dutch | deviatie; skew deviation |
