superior_oblique_palsy_surgery_bilateral

Surgery for Bilateral Superior Oblique Palsy

ClassHTVIOOASOUATorsionDMRAHPTreatment
1No22>+2-1 to 0No10°NoBIOc
2No160 to +1> -2Yes13°Chin downBSOt or Harada-Ito
3No40> +2> -2Yes14°Chin downBIOc & BSOt or Harada-Ito∗
4aYes21> +2 asym> -2Yes14°TiltBilat. Harota-Ito or SOt and unicaat IOc
4bYes20+1 to +2> -2 asymYes12°TiltBSOt or Harada-Ito & IRc or SRc ± BIOc
4cYes22> +2 asym > -2 asymYes15°TiltBIOc & BSOt or Harada-Ito & IRc or SRc
5 ★Yes10> +2 unilat-1 to -3 unilatNo6°-11°TiltUnilat IOc ± IRc brings out contralateral SOP

HT: Hypertropia in primary gaze
V: mean amount of V pattern present in upgaze/downgaze
IOOA: Inferior oblique over action
SOUA: Superior oblique under action
Torsion: Subjective torsion
DMR: Average torsion on Double Maddox Rod test
AHP: Abnormal head position
Treatment: Suggested treatment
BIOc: Bilateral Inferior Oblique recessions or other weakening procedure
BSO Tuck: Bilateral Superior Oblique Tuck
IRc: Inferior rectus recession
SRc: Superior rectus recession
Asym: Asymmetrical under or over action
Bilat: Bilateral
Unlat: Unilateral
SOP: Superior Oblique Palsy

∗ For class 3 patients: consider Bilateral Medial Rectus Recessions for Esodeviation >8 diopters
★ Masked Bilateral Superior Oblique Palsy (9-16% of all Bilateral Superior Oblique palsies)

Based on Scott WE, Kraft SP. Classification and Treatment of Superior Oblique Palsies:II. Bilateral Superior Oblique Palsies. Transactions of the New Orleans Academy of Ophthalmology. 1986: 265-91.

  • superior_oblique_palsy_surgery_bilateral.txt
  • Last modified: 2015/11/09 21:53
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