Dog-bite syndrome: an approach to its management

Five cases of the dog-bite syndrome--palsy of the superior oblique muscle and a paradoxic inability to elevate the eye in adduction--are described. It is suggested that no treatment be given in the acute phase unless there are symptoms in the primary position, in which case peritrochlear injection of a depot steroid within 2 weeks of the injury may be of benefit. If after several months the ocular motility is still significantly restricted an attempt can be made to remove local scar tissue, with insertion of anchor sutures; recession of the inferior rectus of the fellow eye with adjustable sutures should correct residual symptomatic hypertropia.