A Case of Congenital Inferior Oblique Palsy

Kwan Hoon Lee; Seong Eun Kyung

doi:10.3341/jkos.2008.49.5.865

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Lee and Kyung: A Case of Congenital Inferior Oblique Palsy

Original Article

J Korean Ophthalmol Soc 2008;49(5):865-870.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.5.865

A Case of Congenital Inferior Oblique Palsy

Kwan Hoon Lee, M.D., Seong Eun Kyung, M.D.

Department of Ophthalmology, College of Medicine, Dankook University, Cheonan, Korea

Address reprint requests to Seong Eun Kyung, M.D. Department of Ophthalmology, College of Medicine, Dankook University Hospital #San 16-5 Anseo-dong, Cheonan-si, Chungcheongnam-do 330-715, Korea Tel: 82-41-550-6497, Fax: 82-41-561-0137, E-mail: kseeye@hanmail.net

Received 26 July 2007 Accepted 27 December 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Paresis of the inferior oblique is the least likely to result in paralysis. We report a patient without a history of trauma successfully treated using contralateral IO recession and SR recession.

Case summary

A 25-year-old male patient presented to us with an extended history of abnormal head posture, manifested by a marked habitual left head tilt with a face turn to the right. A cover test in the primary position demonstrated 15 prism diopter right hypertropia, which increased to 25 prism diopter right hypertropia in right gaze and 20 prism diopter right hypertropia in right head tilt. The patient was diagnosed with IO palsy, and a right IO recession was performed.

Results

Following the IO recession, head tilt was completely resolved and face turn to the right was slightly resolved. Cover test in the primary position demonstrated 12 prism diopter right hypertropia, which increased to 20 prism diopter right hypertropia in right gaze. A head tilt test demonstrated a symmetrical 12 prism diopter right hypertropia. We performed a right SR recession to decrease face turn and hypertropia in the primary position.

Conclusions

We report a patient manifesting abnormal head posture diagnosed with IO palsy, which was successfully treated using contralateral IO recession and SR recession.

Keywords: Congenital inferior oblique palsy, Inferior oblique anterior transposition

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