hypophoria
Hypophoria is a latent downward deviation of one eye, the downward counterpart of hyperphoria.1 A right hyperphoria is the same deviation as a left hypophoria, and the term hypophoria is not in general use.2 By convention, a vertical phoria is named for the eye that misaligns higher.3
The convention gives way if a diagnosed pathology causes the deviation. In thyroid eye disease, inferior rectus involvement often produces a hypophoria, and recording a hypophoria of the eye with the involved muscle is more clinically correct.3 Vertical heterophoria occasionally occurs in one eye only, and that eye is usually amblyopic.2
More detail
In heavy eye syndrome, anisometropia, usually with high myopia, accompanies a vertical deviation, and the more myopic eye is the hypotropic or hypophoric one. The cause is an abnormally low muscle path of the lateral rectus in that eye, and the vertical deviation ranges from 2 to 25 prism diopters.2
Sources (6)
- Kanski, Clinical Ophthalmology (2024), ch. 18
- Pickwell's Binocular Vision Anomalies, ch. 9
- Scheiman and Wick, Clinical Management of Binocular Vision, ch. 14
- Rutstein, R., Daum, K. (1997). Anomalies of Binocular Vision: Diagnosis & Management, Mosby.
- Caloroso, E.E., Rouse, M.W. (1993). Clinical Management of Strabismus. Butterworth-Heinemann.
- Scheiman, M., Wick, B. (2014). Clinical Management of Binocular Vision: Heterophoric, Accommodative, and Eye Movement Disorders. 4th ed., Lippincott Williams & Wilkins.
Reviewed October 2026