People with SCI are at especially high risk for respiratory and cardiovascular problems, so hospital staff must be watchful to avoid them. Respiratory problems (especially pneumonia) are the leading cause of death in people with SCI, followed by infections, usually of pressure sores, urinary tract infections and respiratory infections. Pneumonia can be accompanied by shortness of breath, fever, and anxiety.Another potentially deadly threat to respiration is deep venous thrombosis (DVT), in which blood forms a clot in immobile limbs; the clot can break off and form a  pulmonary embolism, lodging in the lung and cutting off blood supply to it. DVT  is an especially high risk in SCI, particularly within 10 days of injury, occurring in over 13% in the acute care setting. Preventative measures include anticoagulants, pressure hose, and moving the patients limbs. The usual signs and symptoms of DVT and pulmonary embolism may be masked in SCI cases due to effects such as alterations in pain perception and nervous system functioning.Urinary tract infection (UTI) is another risk that may not display the usual symptoms (pain, urgency, and frequency); it may instead be associated with worsened spasticity. The risk of UTI, likely the most common complication in the long term, is heightened by use of indwelling urinary catheters. Catheterization may be necessary because SCI interferes with the bladders ability to empty when it gets too full, which could trigger autonomic dysreflexia or damage the bladder permanently.
Congenital cases may have developmental abnormality due to abnormal muscle structure, usually muscle atrophy / hypertrophy or rarely, absence of the muscle and incorrect placement. Specific & common causes include:

Superior oblique Palsy / Congenital fourth nerve palsy
Inferior oblique overaction
Browns syndrome
Duanes retraction syndrome
Double elevator palsy
Fibrosis of rectus muscle in Graves Disease (most commonly inferior rectus is involved)
Surgical trauma to the vertical muscles (e.g. during scleral buckling surgery or cataract surgery causing iatrogenic trauma to the vertical muscles).Sudden onset hypertropia in a middle aged or elderly adult may be due to compression of the trochlear nerve and mass effect from a tumor, requiring urgent brain imaging using MRI to localise any space occupying lesion. It could also be due to infarction of blood vessels supplying the nerve, due to diabetes and atherosclerosis. In other instances it may be due to an abnormality of neuromuscular transmission, i.e., Myasthenia Gravis. Treatment
In general, strabismus can be approached and treated with a variety of procedures. Depending on the individual case, treatment options include:

Correction of refractive errors by glasses
Prism therapy (if tolerated, to manage diplopia)
Vision Therapy
Patching (mainly to manage amblyopia in children and diplopia in adults)
Botulinum toxin injection
Surgical correctionSurgical correction of the hypertropia is desired to achieve binocularity, manage diplopia and/or correct the cosmetic defect. Steps to achieve the same depend on mechanism of the hypertropia and identification of the offending muscles causing the misalignment.