Case of the week 58 (
June 2012 ) Left Superior Oblique Palsy
20 years old girl
complaining of this anomalous head posture , the
mother noticed that since only 2 years but old
photos tell that this AHP was present since
early childhood, she denied diplopia , vision is
normal OU, no history of trauma or any general
illness
See video of this patient
Superior
oblique palsy is the most common oculo-motor nerve
palsy encountered by strabismologists and should not
present any diagnosis difficulties .
when a strabismologist is asked about head tilt
found in old photographs , the diagnosis of
congenital superior oblique palsy
should arise as a first possibility.
The 3 step test
(positive Bielschowsky test) - Hypertropia in
the primary position increases on looking nasally
and on head tilt to the same side of the hypertropia
- is diagnostic of SO palsy In cases of class I superior oblique palsy
like this case with a maximum hyperdeviation of no greater than 25
prism diopters weakening of the antagonist inferior
oblique is effective.
الموقع المصري للحول
وامراض الجهاز الحركي للعين
The Egyptian Site of
Strabismus & Oculomotor Disorders
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