
Causes: commonest cause is trauma; vascular (DM, HTN, and arteriosclerosis).
Clinical Manifestations:
1- Hypertropia of the affected Eye in primary position.
2- Diplopia on looking down and in (down stairs, reading).
3- Limitation of movement (Depression of adducted eye).
4- Abnormal head position to avoid Diplopia head tilt to opposite side.









