Asymmetric “hang-back” superior oblique recession

Abstract

Despite their unpredictability, superior oblique weakening procedures are indicated in specific clinical situations. Brown syndrome, inferior oblique paresis, and primary overaction of the superior oblique muscle can all cause symptomatic hypotropia, especially on adduction, and may be associated with anomalous head postures to allow fusion. The torticollis may be chin-down if the patient has an A-pattern exotropia, chin-up if an A-pattern esotropia, or tilted to the side of the affected eye if an inferior oblique paresis.