Surgical Outcome for Congenital Superior Oblique Palsy with Paradoxical Head Tilt

Kim, Joong-Hun; Kim, Seung-Hyun

Case Report

Annals of Optometry and Contact Lens 2018;17(4):114-117.
Published online December 25, 2018.

역설머리기울임을 보인 선천상사근마비 환자의 수술 결과

김중훈, 하석규

GS안과¹,
고려대학교 의과대학 안과학교실²

Surgical Outcome for Congenital Superior Oblique Palsy with Paradoxical Head Tilt

Joong-Hun Kim, Seung-Hyun Kim

GS Eye Center¹, Seoul, Korea, Department of Ophthalmology, Korea University College of Medicine² , Seoul, Korea

Received: 7 August 2018 • Revised: 9 November 2018 • Accepted: 9 November 2018

Abstract

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.

Key Words: Head tilt; Superior oblique palsy; Surgery