Abstract

Inferior rectus hypoplasia is a rare congenital disorder characterised by underdevelopment or hypoplasia of inferior rectus muscle resulting in hypotropia and limited infraduction. This case reports a 7 year old girl with chief complaint of right hypotropia and limited downward eye movement in her left eye.The patient had significant hypotropia of 20 degrees in right eye in primary gaze, with limuted infraduction in the left eye. MRI imaging confirmed the presence of inferior rectus hypoplasia on the left sideThe surgical management consisted of inferior oblique anterior transposition in right eye to increase its elevation and medial rectus recession in left eye to address the limited infraduction and shifting of left lateral rectus to inferior rectus to improve the downgaze.Over several weeks, her ocular alignment has improved, right hypotropia decreased to 5 degrees in primary gaze, with significant improvement in infraduction and complete resolution of diplopia.