[Paresis of the superior oblique eye muscle]. / Parese av øvre skrå øyemuskel.

Congenital or acquired palsy of the superior oblique eye muscle presents a clinical picture which is consistent and recognizable. The diagnosis is based upon two clinical findings: hypertropia of the affected eye with a greater than normal vertical deviation in adduction, and an increase of the hypertropia when tilting the head towards the affected side (positive Bielschowsky test). In the majority of cases the dominant feature of the clinical picture is overreaction of the ipsilateral inferior oblique. We have retrospectively examined 22 patients with superior oblique palsy who underwent surgery. Median follow-up time was three months. 20 (91%) of the patients were operated primarily by performing a recession of the ipsilateral inferior oblique muscle. Additional surgery had to be performed on five patients. The final postoperative examination showed the result to be a success in 19 (86%) of the patients, judged on relief of symptoms and objective measurements. We conclude that in the majority of cases surgical treatment of superior oblique palsy by recession of the ipsilateral inferior oblique gives good results.

[Surgical treatment of concomitant strabism in children younger than 15 years. Results 6 weeks after surgery]. / Kirurgisk behandling av konkomiterende strabisme hos barn under 15 år. Resultater seks uker postoperativt.

In order to evaluate the short-term results we carried out a retrospective study on 104 children who had been operated on in 1993 for concomitant convergent (n = 74) and divergent (n = 30) strabismus. Six weeks after the operation an alignment within 0-10 delta was achieved in 64% of the convergent children and 44% of the divergent children. When we evaluated the subgroups of children with convergent strabismus we found a postoperative alignment within 0-10 delta in 54% of the patients with strabismus from before six months of age (infantile esotropia), and in 93% of the children in whom the strabismus was present from after two years of age. In the total material we could demonstrate an improvement in binocular function in 17%. Based on a total evaluation we consider that 80% obtained a good postoperative result. We believe that continual, computer-based evaluation of the strabismus patients would be a valuable tool to further improve our results.