PURPOSE This study was undertaken to investigate evidence for a connective tissue pulley constraining the path of the inferior oblique (IO) muscle. METHODS From magnetic resonance images, the cross-sectional area, path, and orbital relationships of the human IO were determined in multiple gaze positions. Rectus pulleys were directly imaged with intravenous gadodiamide contrast. Images were co...

I n t e rnational scholars have addressed various issues related to superior oblique palsy (SOP) many times in recent years owing to its epidemiologic relevance (1-3). Recently, it has been recognized as a leading cause of anomalous head posture in the pediatric age group (4). In this issue, two studies analyze the results of inferior oblique (IO) weakening pro c e d u res in the treatment of S...

Brown's syndrome, the limitation of upgaze in an adducted eye relating to a malfunction of the superior oblique tendon and trochlear complex, is well recognised in the ophthalmological literature1 but is rarely reported in the neurological literature2 and does not appear in a range of standard neurological textbooks. We report a young woman with Brown's syndrome who was initially thought to hav...

Vertical fusional vergence (VFV) normally compensates for slight vertical heterophorias. We employed magnetic resonance imaging to clarify extraocular muscle contributions to VFV induced by monocular two-prism diopter (1.15°) base-up prism in 14 normal adults. Fusion during prism viewing requires monocular infraduction. Scans were repeated without prism, and with prism shifted contralaterally. ...

OBJECTIVE To report the effect of weakening the superior rectus and inferior oblique (IO) muscles on ocular rotations. DESIGN Observational case series. We reviewed a 10-year period of medical records of consecutive patients who underwent bilateral 5- to 11-mm (mean, 8.0 mm; SD, 1.1 mm) superior rectus muscle recessions combined with an IO muscle recession, myectomy, or anterior transposition...

A 70-year-old man with thyroid associated ophthalmopathy showed inflammatory swelling of the left inferior oblique muscle that was significantly improved by steroid pulse therapy and radiotherapy. Sagittal T2-weighted magnetic resonance images were useful to detect the lesion and to evaluate the effects of treatment.

We herewith report the rare case of a patient with juvenile rheumatoid arthritis who developed on 2 occasions the clinical picture of an isolated unilateral palsy of the inferior oblique muscle—Brown’s syndrome, following pregnancies, each time in a different eye. Although the eye is frequently involved in rheumatoid arthritis (RA), the Brown’s syndrome is seldom reported in literature with reg...

Transconjunctival blepharoplasty is a commonly performed procedure. Corneal protection, avoidance of damage to the inferior oblique muscle of the eye, avoidance of hemorrhage from the fat pads, and adequate fat removal are important considerations when transconjunctival blepharoplasty is performed. The described surgical technique provides consistently satisfactory results and avoids the use of...