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1. Congenital extensive fibrosis of extraocular muscles is a rare disease with family inheritance and is a dominant genetic disease. It is characterized by ptosis in both eyes, fixed in the position of looking down, significantly limited eye movement (up, down and horizontal rotation), adhesion between extraocular muscles, eyeball fascia and eyeball, positive traction test, and fibrosis of most or all extraocular muscles. The elasticity of bulbar conjunctiva is reduced, and the mandible is lifted up and the head is tilted back.
2. Congenital complete paralysis of inferior rectus muscle and high contracture of superior rectus muscle, which is difficult to distinguish from congenital absence of inferior rectus muscle in appearance. The differential point is that the slope of the disease does not increase with age, and there can be obvious compensatory head position. Therefore, the possibility of congenital absence of inferior rectus muscle should be considered during operation.
3. Vertical recession syndrome. The lower rectus muscle may have a certain degree of movement restriction. When the eyeball rotates upward to the temporal side, it is accompanied by eyeball recession and eyelid fissure reduction, which can be distinguished from the absence of the lower rectus muscle.
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