Unilateral Superior Oblique Palsies (Illustrated for Right SOP)
Class | R.Hyper | R.gaze | SOUA | IOOA | Treatment |
1 | <15 | None | 0 to -1 | +2 to +3 | RIOc |
2 | <15 | None | -1 to -2 | +3 to +4 | RIOc vs myectomy |
3a | <15 | None | -2 to -4 | 0 to +1 | LIRc |
3b | <15 | As 3a but with sig torsion | RSOt or Harada Ito + LIRc | ||
4 | >15 | Sig. | 0 to -2 | +3 to +4 | RIOc + RSRc |
5 | >15 | Sig. | -2 to -3 | 0 to +2 | RIOc + LIRc |
6 | >30 | Sig. >15 | -2 to -3 | +3 to +4 | RIOc + LSRc & LIRc |
7a | <15 | With spread of commitance | RSRc | ||
7b | >15 | With spread of commitance | RSRc + RIRs or LIRc | ||
8 | <20 | Fallen eye syndrome | LIRc |
SOP: Superior Oblique Palsy
Sig: significant
SOUA: Superior oblique underaction
IOOA: Inferior oblique overaction
Treatment: Suggested treatment
RIOc: Right Inferior Oblique recessions or other weakening procedure
RSOt: Right Superior Oblique Tuck
LIRc: Left Inferior rectus recession
LSRc: Left Superior rectus recession
RSRc: Right Superior rectus recession
RIRs: Right Inferior rectus resection
Based on Scott WE, Kraft SP, Classification and Treatment of Superior Oblique Palsies:I. Unilateral Superior Oblique Palsies. Transactions of the New Orleans Academy of Ophthalmology. 1986: 15-38.