Monocular elevation deficiency ("Double elevator" palsy): A cautionary note

Monocular elevation deficiency (or "double elevator" palsy) is a descriptive term denoting a congenital deficiency of monocular elevation that is equal in abduction and adduction. We describe a child with monocular elevation deficiency who displayed tethering and buckling of the central lower eyelid in downgaze. We caution that this manifestation of inferior rectus contracture can simulate impaired infraduction in the involved eye.