Esotropia-hypertropia complex in a patient with myopic strabismus fixus.

Patients with highly myopic strabismus generally develop esotropia and hypotropia. We report the case of a 54-year-old woman with a combination of esotropia-hypertropia complex in the right eye and esotropia-hypotropia complex in the left eye, with unilateral congenital severe ptosis. The patient had inferotemporal prolapse of the globe in the right eye. Inferotemporal prolapse in this case could have been due to extraocular muscle pulley dehiscence in this area, causing the inferior oblique muscle to slip around the globe along the path of least resistance. Subsequently, the inferotemporal staphyloma would have prevented the typical esotropia and hypotropia of the globe.