A Case of Surgery for Congenital Superior Oblique Palsy with Intorsion of Nonparalized Eye

Choi, Yun Young; Lee, Soo Young

Abstract

PURPOSE
Superior oblique palsy characterizes the abnormal oblique muscle function and excyclotorsion of paralized eye, and facial asymmetry and spread of comitance in long-standing case. We report the clinical aspects and treatment result of a 13-year-old female with congenital superior oblique palsy manifesting nonparalized eye intorsion instead of paralized eye excyclotorsion and intermittent exotropia. METHODS: This patient showed intermittent exotropia and congenital superior oblique palsy characterized by facial asymmetry, ipsilateral superior rectus contracture, abnormal posterior insertion of superior oblique tendon, and contralateral eye incyclotorsion and secondary superior oblique overaction. We operated ipsilateral superior rectus and lateral rectus recession considering these characteristics. RESULTS: There has been no intorsion in nonparalized eye immediately after surgery, and the 9 cardinal gazes have been orthophoric after 2 weeks of surgery. CONCLUSIONS: We report a surgical experience of a congenital superior oblique palsy that has not been reported yet, that showed intorsion of nonparalized eye instead of extorsion.