Hypertropia makes one of your eyes drift or look up uncontrollably. It’s caused by something damaging or interfering with the nerves or muscles that control your eye movements. Your eyes being out of alignment will cause double vision. Visit an eye care specialist as soon as you notice any changes in your eyes or ability to see.
Hypertropia is a condition that makes one of your eyes look up all the time. It’s a form of strabismus.
Strabismus is any condition that affects how your eyes align. In other words, one eye is turned in a direction that’s different from the other eye.
You have six muscles in each of your eyes that control your eye movements. Usually, these muscles work together and point both your eyes in the same direction when you look at something. People with strabismus can’t control their eye movements and can’t maintain ocular alignment (eye position).
If you have hypertropia, your affected eye will pull out of alignment with the other. It’s usually most noticeable when you’re trying to look straight ahead. Your affected eye will always look slightly up — away from the center of your face — even if you’re trying to look in a different direction. You might see this referred to as your eye being out of vertical alignment.
It might feel like your eyes are straining and tired. Some people (especially kids) don’t know they have hypertropia or that something is wrong with their eyes. Your child might tilt their head to see out of their affected eye without even noticing they’re doing it.
Hypertropia can make your vision blurry and can cause double vision (diplopia). Kids and adults who have had strabismus for a long time don’t usually experience double vision.
Even if your child has hypertropia (or other forms of strabismus), that doesn’t mean they’ll have other health conditions that affect their brain or body.
Visit an eye care specialist as soon as you notice any changes in your eyes or vision.
Anyone can experience hypertropia. Around 5% of people in the U.S. have some form of strabismus.
Hypertropia often runs in families, but that doesn’t mean your children will definitely develop it if you’ve experienced hypertropia.
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The most common symptom of hypertropia is one of your eyes being noticeably out of alignment. Sometimes your eyes will alternate positions. When this happens, your unaffected eye might look like it’s pointing down while your eye while your affected eye looks like it’s pointing straight ahead.
Other symptoms of hypertropia include:
Some people with hypertropia only experience symptoms when they’re stressed or tired. An eye care specialist might refer to this as intermittent hypertropia.
Young children who have hypertropia have an increased risk of developing lazy eye (amblyopia). Visit an eye care specialist as soon as you notice any changes or symptoms in your child’s eyes.
Two cranial nerves — cranial nerve III (oculomotor nerve) and cranial nerve IV (trochlear nerve) — control the muscles that move your eyes vertically (up and down). Anything that damages these nerves, muscles or your brain can cause hypertropia, including:
Certain health conditions can cause hypertropia, including:
You can develop hypertropia if the muscles that move your eyes are too tight or too weak.
Other types of strabismus can cause hypertropia. People with horizontal strabismus sometimes develop hypertropia. Dissociated vertical deviation (DVD) is a special form of hypertropia that makes your one or both of your eyes drift up intermittently (only sometimes). DVD usually affects kids with strabismus.
An eye care specialist will diagnose hypertropia with an eye exam. They’ll look at your eye as it moves and while you’re looking straight ahead. They’ll also look inside your eye to rule out other issues that could be affecting it and causing your symptoms.
You might need an MRI or blood tests.
How hypertropia is treated depends on what’s causing it. The most common treatments include:
You probably can’t prevent hypertropia. Because it’s caused by health conditions you can’t control or sudden issues like strokes or eye injuries, there isn’t usually anything you can to prevent it.
In general, make sure you always wear protective eyewear and proper safety equipment while working with tools or doing any activity that could injure your eyes.
Your vision and eye alignment should return to normal after the hypertropia is treated and your eyes are correctly aligned.
Most causes of hypertropia won’t impact your vision long term. However, some people who experience a stroke or eye injury have low vision even after hypertropia is treated.
An eye care specialist will tell you what to expect and how long it will take your eyes to recover.
Having your eyes and vision checked regularly can help an eye care specialist identify problems right away. How often you should get your eyes checked usually depends on your age:
You might need your eyes checked more often than this if you wear glasses, contacts or need another type of visual aid. People with diabetes need their eyes checked more often than what’s listed here.
Ask an eye care specialist how often you need an eye exam.
See a healthcare provider or eye care specialist as soon as you notice any changes in your eyes or vision.
Go to the emergency room if you have any of the following symptoms:
A note from Cleveland Clinic
Hypertropia makes one of your eyes drift or look up, even if you’re not trying to. It’s scary not to be in control of a part of your body you usually are — but hypertropia is very treatable. Hypertropia usually won’t have long-term impacts on your vision.
Depending on what’s causing the hypertropia (and which symptoms you’re having), an eye care specialist will find a treatment that can restore your eyes’ alignment or help with your double vision.
If you notice your child tilting their head, they might have hypertropia. Visit an eye care specialist as soon as you notice any symptoms in their eyes. Young children with untreated hypertropia have an increased risk of developing lazy eye.
Last reviewed by a Cleveland Clinic medical professional on 10/18/2022.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy