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Choi and Choi: Clinical Manifestations of Inferior Oblique Overaction in Patients with Horizontal Strabismus
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(10): 1493-1499.

Published online: 17 October 2012

DOI: https://doi.org/10.3341/jkos.2012.53.10.1493

Clinical Manifestations of Inferior Oblique Overaction in Patients with Horizontal Strabismus

Duk Kyu Choi, MD, Mi Young Choi, MD, PhD

Department of Ophthalmology, Chungbuk National University College of Medicine, Cheongju, Korea.

Address reprint requests to Mi Young Choi, MD, PhD. Department of Ophthalmology, Chungbuk National University Hospital, #776 1Sunhwan-ro, Heungdeok-gu, Cheongju 361-711, Korea. Tel: 82-43-269-6335, Fax: 82-43-264-5263, mychoi@chungbuk.ac.kr

Received 10 March 2012       Accepted 12 August 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To investigate the clinical manifestations of and the surgical success rates in patients with horizontal strabismus and inferior oblique overaction (IOOA).

Methods

The patients included in the present study had received myectomy for correction of IOOA and had at least 3 months of follow-up. The patients were divided into 2 groups; patients who received myectomy and surgery for horizontal strabismus simultaneously (combined group, 74 eyes of 49 patients) and patients who received myectomy only (myectomy group, 29 eyes of 24 patients). Chief complaints, head tilt, bilaterality of IOOA, ocular torsion, and the surgical success rates were analyzed.

Results

In the combined group, 51% of the chief complaints were horizontal deviation, and in the myectomy group 42% were upward deviation and 29% were head tilt. Objective head tilt was 29% in the combined group and 54% in the myectomy group and the difference was significant. There was no significant difference statistically in the success rate of myectomy.

Conclusions

The frequency of symptoms associated with IOOA in the combined group was lower than in the myectomy group. Therefore, preoperative examination regarding IOOA should be carefully performed in patients who are planning a horizontal strabismus surgery because there was no difference in surgical success rate between the 2 groups, the association with horizontal strabismus may have no effect on the surgical results of IOOA.

Keywords: Head tilt, Horizontal strabismus, Inferior oblique overaction

Figures and Tables

Table 1
Baseline characteristics
jkos-53-1493-i001

Values are presented as number of mean ± SD.

*Inferior oblique; †Inferior oblique myectomy + horizontal strabismus surgery; ‡Chi-square test; §Wilcoxon rank sum test.

Table 2
Grade of inferior oblique overaction
jkos-53-1493-i002

Values are presented as number (%).

*Inferior oblique; †Inferior oblique myectomy + horizontal strabismus surgery; ‡Inferior oblique overaction.

Table 3
Chief complaints at initial visit
jkos-53-1493-i003

Values are presented as number (%).

*Inferior oblique; †Inferior oblique myectomy + horizontal strabismus surgery.

Table 4
Clinical findings of inferior oblique overaction
jkos-53-1493-i004

Values are presented as number (%).

*Inferior oblique; †Inferior oblique myectomy + horizontal strabismus surgery; ‡Chi-square test; §Fisher's exact test; ΠInferior oblique overaction.

Table 5
Angle of vertical deviation at primary position
jkos-53-1493-i005

Values are presented as mean ± SD.

*Inferior oblique; †Inferior oblique myectomy + horizontal strabismus surgery; ‡Prism diopter; §Wilcoxon rank sum test.

Table 6
Success rates of myectomy
jkos-53-1493-i006

Values are presented as number (%).

*Inferior oblique; †Inferior oblique myectomy + horizontal strabismus surgery; ‡Chi-square test; §Fisher's exact test.

Table 7
Failure rates of myectomy
jkos-53-1493-i007

Values are presented as number (%).

*Inferior oblique; †Inferior oblique myectomy + horizontal strabismus surgery; ‡Inferior oblique overaction.

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