Superior oblique myokymia, a review

Superior oblique myokymia is a rare, monocular condition that typically presents in healthy adults. In this article, we review the proposed pathophysiology, describe the typical clinical presentation, and discuss the recommended work up and various treatment options.

Treatment for this condition ranges from observation and reassurance to various topical and systemic medications. Both strabismus surgery and neurosurgery are reserved for patients who fail medical therapy or are intolerant to medication secondary to side effects.

Due to its episodic nature, SOM is often under-diagnosed. We highlight key features in a patient's clinical history and the examination findings that suggest and support the diagnosis, with review of available treatment options.