Traumatic rupture of the superior oblique muscle is rare. We report a case of a 54-year-old man injured by the metal hook of a hanger, resulting in a rupture of the superior oblique muscle tendon. He complained of torsional diplopia when in the primary position. The distal margin of the superior oblique muscle was reattached to sclera 5 and 9 mm apart from the medial insertion of the superior r...

A 66-year-old female presented with exotropia and hypertropia of her left eye. She had a previous history of lateral rectus recession and medial rectus resection of her left eye 20 years prior to old oculomotor and trochlear nerve pareses. She was treated with a botulinum toxin injection in the inferior oblique and lateral rectus muscles of her affected eye. In this case, the patient’s exotropi...

PURPOSE To evaluate the effectiveness of graded (adjustable intraoperatively) partial vertical rectus muscle tenotomy at the insertion in correcting small degrees of hypertropia. METHODS All patients with best-corrected visual acuity of better than 6/30 in both eyes who over a 30-month period underwent partial tenotomy of vertical rectus muscle(s) only (no concurrent oblique muscles) were inc...

Dr. Nelson has no financial or proprietary interest in the materials presented herein. doi:10.3928/01913913-20171212-01 The treatment of small angle hypertropia in the primary position with inferior oblique overaction is often a dilemma for pediatric ophthalmologists. Some patients have a face turn and diplopia in the primary position as well as in side gaze. Prisms are often unsatisfactory bec...

PURPOSE To evaluate the outcomes of botulinum toxin injection into the inferior oblique (IO) muscle for management of unilateral acute traumatic superior oblique (SO) palsy. METHODS In this prospective case series, 10-20 units of botulinum toxin A (Dysport, Ipsen, Biopharm Ltd., Wrexham, UK) was injected into the ipsilateral IO muscle of 13 consecutive patients with unilateral acute traumatic...

OBJECTIVE To describe the clinical features, etiology, and management of superior oblique tendon incarceration syndrome. METHODS This series consists of all patients I treated between September 15, 1974, and March 1, 2006, for restrictive hypertropia in which the superior oblique tendon was found scarred to the superior rectus muscle insertion after prior surgery. RESULTS Twenty eyes in 18 ...

BACKGROUND AND PURPOSE To determine the diagnostic utility of the three-step test in unilateral superior oblique palsy (SOP) according to the presence of the trochlear nerve using high-resolution thin-section magnetic resonance imaging. METHODS In total, 166 patients with congenital and acquired unilateral SOP were included, comprising 87 with a normal trochlear nerve (present group) and 79 w...