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A 20-year-old lady presented with drooping of left upper eyelid since childhood. After detailed examination she was diagnosed to have congenital monocular elevation deficiency and exotropia in the left eye. Sequential surgical correction procedures were performed to treat her left eye condition i.e., first surgery to correct exotropia (recession and resection of the horizontal recti), second surgery to correct hypotropia (recession and resection of vertical recti) without Knapp’s or modified Knapp’s proceadure. Left eye was looking straight in primary position; however, there was hypertropia in the right eye. Third surgery was done to correct hypertropia in the right eye (recession and resection of vertical recti) following which both eyes were straight in primary position. Even though the patient has undergone surgery three times, she was very happy with good cosmetic results.

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