probably because the lacrimal sac lies at the level of superior and middle meatus

@tamilselvan.r8262 This is without a doubt simple hyperopic astigmatism. Transpose & you will realise

@@ophthalmologypearls thank you madam 🫡🫡

Thank you! Unfortunately the guidelines for inclusion in with rule and against the rule are not freely available in the literature. At least not in a reliable source. Smolin and Thoft mentions 15 degrees on either side of the vertical and horizontal as the limits. Since this is a standard book, one can take those values

@AlexMorenson, Like I mentioned in the video the full range is considered zero - one would be 25% restriction, - 2 would be 50% restriction and -3 would be 75% restriction. - 4 would indicate no movement pass the midhorizontal line. These are approximations the Kestenbaum test is measurable and more objective

@AlexMorenson, there is no indication of any landmarks that we can use that is mentioned in the literature

@@ophthalmologypearls Thanks for responding! I guess my confusion is what is considered "full range" for superior and inferior gaze? For example is full range for superior gaze when the edge of the iris is crossing the mid horizontal line? Or is it full when the distance the iris moves is equivalent to the distance from the horizontal mid line to the top of eye lid aperture?

@@AlexMorenson I did not find this information even after an extensive literature search. I cannot put information that is not authentic out there. If you however, do come across this information anywhere please do let me know

@greeshmabindu2858. Thank you so much for the support 🙂

Are you a UG or PG?

@@ophthalmologypearls fellow madam

@drbhatt717 Steinert's cataract surgery

@tamilselvan.r8262 Right eye

@@ophthalmologypearls thank you madam