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Dr. Chan
Dr. Chan, Ophthalmologist
Category: Eye
Satisfied Customers: 356
Experience:  Board Certified in ophthalmology
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my 2 year old can not look up. he moves his head to look up

Customer Question

my 2 year old can not look up. he moves his head to look up at something rather than just his eyes. he can move side to side and downward but not up. what could be the cause.
Submitted: 7 years ago.
Category: Eye
Expert:  Dr. Chan replied 7 years ago.



How long have you noticed this? Is it both eyes or just one eye? Is his eyelid(s) droopy? Does he have any other medical conditions?

Customer: replied 7 years ago.
Initially,about 3 months ago but it only lasted for a day. THe past week he started again and now is more consistent. It is both eyes. His eyelids are not droopy. He is otherwise healthy. There is no family history of eye problems other than near-sightedness.
Expert:  Dr. Chan replied 7 years ago.



First of all, we have to distinguish whether the problem of looking up is in both eyes or just one eye. A child will not look up, even if the paralysis is just in one eye, because he would have double vision when he looks up. In order to determine whether the palsy is in one eye or both, you have to cover one eye at a time and test the uncovered eye by itself.


The reason I make a big deal of this is that the diagnosis is grossly different if its in one eye versus both eyes. If both eyes are paralyzed from looking up, then the only possible cause is something affecting the midbrain. That means he needs and MRI.


If the palsy is only in one eye, then it could be in the brain stem or eyesocket. Either way, since this palsy is new, your son needs a complete examination with an ophthalmologist and a brain scan.


Hope this helps.

Customer: replied 7 years ago.

We went to the eye doctor and he is not ruling out the possibility of my son's problem being allergy's. We held off on the MRI for now and are using a steroid type eye drop. What is your opinion on the this. The optomitrist did an examination of his eyes and everything else looks fine.

Expert:  Dr. Chan replied 7 years ago.



If the child's eye(s) truly cannot look up. If the muscle is weakened, that can't be from allergies.

Customer: replied 7 years ago.

If you can force him to he can raise them slightly. the ophthalmologist can not see him until july 27. now if it is muscle related what can be done for that? is this sort of thing common in young children?

Expert:  Dr. Chan replied 7 years ago.



It is usually not a muscle problem. It is usually a nerve problem. With a weak nerve, the muscle becomes weak. The key is to determine what the problem is with the nerve. This is where he may need a head/brain scan.


There are surgeries that can be performed to help with motility of the eyes.

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