Lincoln's vertical strabismus

Background: The vertical strabismus manifested by Abraham Lincoln has been noted. This article reviews the historical findings and provides a specific diagnosis. Materials: Previous reports of symptoms and history relating to Lincoln's left hypertropia were reviewed. A series of photographs were reviewed. Lincoln's own description of his symptoms is provided. Results: Previous history indicates an intermittent left hypertropia. A family history of vertical strabismus was noted with regard to Mr Lincoln's cousin. There also is a history of trauma to the left frontal area and life-mask evidence of fracture over the left eye, The findings include a history of head tilt and diplopia, presumably most readily in downgaze. Conclusion: Given the history and findings, the diagnosis of left superior oblique paresis of either congenital or traumatic origin seems appropriate.