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Surgical Outcome for Congenital Superior Oblique Palsy with Paradoxical Head Tilt
Ann Optom Contact Lens 2018;17:114-117
Published online December 25, 2018
© 2018 The Korean Optometry & Contact Lens Study Society

Joong-Hun Kim, MD1, Suk-Gyu Ha, MD, PhD2, Seung-Hyun Kim, MD, PhD2

GS Eye Center1, Seoul, Korea, Department of Ophthalmology, Korea University College of Medicine2 , Seoul, Korea
Correspondence to: Seung-Hyun Kim, MD, PhD
Department of Ophthalmology, Korea University, #73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea
Tel: 82-2-920-5521, Fax: 82-2-924-6820
Received August 7, 2018; Revised November 9, 2018; Accepted November 9, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: We report the surgery outcome of three cases with congenital superior oblique palsy (SOP) with paradoxical head tilt
after conducting ipsilateral inferior oblique (IO) recession.
Case summary: Case 1 was a 4-year-old boy with right head tilt noted since about 3-4 months of age. He demonstrated right hypertropia of 6 prism diopters (PD). Case 2 was a 4-year-old girl who demonstrated left hypertropia of 6 PD and exotropia of 18
PD. She had shown intermittent left head tilt since about 3 months of age. Case 3 was a 8-year-old boy with right head tilt noted
since about 1 year of age. He demonstrated right hypertropia of 10 PD. Case 1 underwent left IO recession and left lateral rectus
recession. Case 2 and 3 underwent right IO recession.
Conclusions: Ipsilateral IO weakening was also the effective surgery in congenital SOP with paradoxical head tilt as well as in
the one manifesting usual head tilt.
Keywords : Head tilt; Superior oblique palsy; Surgery

December 2018, 17 (4)