title: [Treatment of spontaneous dissociated vertical deviation with the pharmacological penalization of the fixing eye].
abstract: BACKGROUND
  Dissociated vertical deviation (DVD) is a common innervational entity frequently found in patients with congenital endotropia. It is characterized as being bilateral, asymmetric, and to a greater extent, in the non-fixating eye. It can be compensatory or non-compensatory. In the majority of cases, surgery is the treatment of choice, but spontaneous appearance of DVD is a common occurrence after surgery, sometimes to a degree similar to that prior to surgery.
  
  
  OBJECTIVE
  Our aim was to evaluate the behavior of dissociated vertical deviation with penalization of the fixating eye.
  
  
  METHODS
  An experimental and longitudinal study was conducted in which patients with spontaneous DVD were included, whether or not associated with horizontal deviation, with or without previous surgery. Atropine (1%) was applied every 24 h in the fixating eye for 3 months and DVD presence, magnitude, and spontaneity were evaluated at 15 days, 1 month, 3 months, and 1 month after penalization suspension.
  
  
  RESULTS
  Eight patients were included. DVD magnitude decreased with penalization (p = 0.02) and remained unchanged when atropine was suspended (p = 0.6). With regard to decompensatory phases, DVD shifted from spontaneous to non-spontaneous during penalization (p = 0.01); when this was eliminated, deviation showed decompensation again (p = 0.03).
  
  
  CONCLUSIONS
  Fixating eye penalization with 1% atropine reduces DVD magnitude and decompensatory phases during follow-up.
authors.affiliation: Clínica de Oftamología Pediátrica y Estrabismo, Servicio de Oftalmología del Hospital General de México, OD. mearroyo1@prodigy.net.mx
authors.forename: María Estela
authors.initials: ME
authors.lastname: Arroyo-Yllanes
authors.forename: Blanca Adriana
authors.initials: BA
authors.lastname: Galicia-Castillo
authors.forename: José Fernando
authors.initials: JF
authors.lastname: Pérez-Pérez
mesh_terms: D001285:Atropine / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000188:drug therapy* / Q000601:surgery*
chemical_list: D001285:Atropine