Aberrant regeneration after traumatic oculomotor nerve palsy causing paradoxical infraduction on attempted supraduction.

A 52-year-old man was referred to our strabismus clinic for evaluation of abnormal ocular motility of the right eye of 40 years' duration that resulted from childhood trauma, when he had suffered a head contusion in an automobile accident. Immediately after the injury, he had ophthalmoplegia and ptosis in the right eye and was diagnosed with oculomotor nerve palsy. The present examination revealed a right exotropia of 35Δ and a hypotropia of 25Δ in the primary position at both near and far fixation. However, the right eye did not move upward on attempted supraduction; furthermore, infraduction on attempted supraduction was observed in the right eye.