Superior oblique paresis after blepharoplasty

Area of Science:

• Ophthalmology
• Strabismus Surgery
• Neuro-ophthalmology

Background:

• Superior oblique palsy can lead to debilitating torsional diplopia and compensatory head tilt.
• Iatrogenic injury to the superior oblique tendon during ocular surgery is a rare but significant complication.

Observation:

• A patient presented with symptoms suggestive of superior oblique paresis.
• The paresis was temporally associated with cauterization of the superior oblique tendon during a prior surgical procedure.

Findings:

• The patient experienced significant torsional diplopia and a characteristic head tilt.
• Surgical recession of the contralateral inferior rectus muscle successfully corrected the ocular misalignment.

Implications:

• This case highlights a potential iatrogenic cause of superior oblique paresis.
• Contralateral inferior rectus recession can be an effective treatment for specific types of superior oblique palsy.
• Understanding this surgical complication is crucial for preventing and managing strabismus abnormalities.