Topical anesthesia for inferior rectus recession in thyroid ophthalmopathy

The restrictive hypotropia seen in thyroid patients is most commonly due to an infiltrative myopathy of the inferior rectus muscle. With the described technique, using topical anesthesia, the degree of muscle contraction and inelasticity determines where the inferior rectus should be placed to permit full upgaze. This provides full correction of the restrictive hypotropia with the least possible amount of muscle recession.