skew deviation

Full Definition

A vertical ocular misalignment caused by disruption of otolithic pathways in the brainstem or cerebellum, not attributable to weakness of individual extraocular muscles. The hypertropic eye varies depending on gaze direction and head position, distinguishing it from fourth nerve palsy. Often associated with other brainstem signs such as nystagmus or vestibular dysfunction. Can be comitant or incomitant and may alternate between eyes.

Usage

Usage note: Do not hyphenate as a noun; may be hyphenated as an adjective.

In Context

• "The alternating skew deviation suggested a central vestibular lesion rather than peripheral pathology." — Neuro-ophthalmology assessment
• "Skew deviation was confirmed by the absence of superior oblique muscle weakness on forced duction testing." — Oculomotor evaluation report