Recent developments in the field of superior oblique palsies

The superior oblique muscle is a complex structure that evidences considerable variation in its anatomy as well as its rotational effects upon the eye. Our understanding and treatment of patients with superior oblique dysfunction are complicated by our incomplete, though developing, understanding of the sensory and motor adaptations to these dysfunctions. We review articles published over the previous year, which further our understanding of these issues.

A thought-provoking three-part series, using monkeys this past year, may provide some insights into time-dependent changes after superior oblique palsy as well as stimulate some interesting conjecture about what, if any, role proprioception may have in strabismus patients. There are some studies, which further our understanding of the torsional effects in superior oblique palsy, the fusional capabilities of normal and palsied patients, and the changes that our surgeries create in the torsional state of the eye. Another case of an ocular torticollis associated with plagiocephaly is presented this year. This past year also saw continuing attempts to determine the best methods for surgically correcting a superior oblique palsy.

Superior oblique muscle dysfunction continues to stimulate research into its complex and varied clinical manifestations.