Eyes (iris) slightly higher than normal

[medstudent89]

My eyes (iris+pupil) is higher than normal, with the right eye being a bit higher than the left eye. For example, when i look at someone in the eyes, they tell me i am looking at their forehead or higher. For me to make eye contact, it appears i have to stare a bit lower (mouth/nose region). The eyes seem to be normal level when adducted, but higher when abducted. Is it possible to have some sort of muscle weakness in only the inferior rectus muscles??  Any help would be appreciated, thank you. (I only recently found out because someone pointed it out, so i'm not sure how long it has been like this, but i haven't suffered any head trauma or anything similar)

[John C Hagan III, MD, FACS, FAAO]

It is possible to have an isolateed inferior rectus weakness but its very rare for a number of reasons. You might have an exotrophia. People with this problem often complaint that people keep asking what they're looking at or look over their shoulder to see "what you're looking at". Or you could have Duane-Stilling-Tuck Sydrome.

If you are a medical student you should make an appointment in your Department of Ophthalmology with a pediatric/adult strabismus eye physician.

Or if you live in USA go to www.geteyesmart.org and find one near you.

JCH MD

[achillea]

A similar phenomenon was often mentioned about Abraham Lincoln's eyes.  The left one was prone to 'wander,' according to contemporaries.  You can see the asymmetry here:

http://www.whitehouse.gov/sites/default/files/first-family/masthead_image/16al_header_sm.jpg?1250877868

All kinds of causes, from migraines to strabismus to a horse-kick in the head to Marfan's Syndrome, have been mentioned, but the eye peculiarity seems not to have hindered him greatly.