Tonic upward ocular deviation without seizure activity or neurologic disease is reported in 3 infants from the Pediatric and Neuro-ophthalmology Units, School of Medicine, University of California, San Francisco. The frequency and duration of the tonic upgaze episodes decreased with time but were exacerbated by fatigue or illness. Downward eye movements were normal. 
COMMENT. Transient tonic downward gaze in newborns is a fairly common phenomenon whereas tonic upgaze deviation is rarely reported, except with seizure activity, visual loss, or brain-stem disease. The pathophysiology of this transient variety of tonic upgaze is unknown but appears to differ from that of the downgaze type, being more persistent and exacerbated by fatigue or illness.