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Cohort studyJournal of binocular vision and ocular motility · 2026

Superior Oblique Palsy: Characteristics and Treatment Outcomes.

Sanpaporn Uttamapinan, Chanikarn Preechawuttidej, Natthiya Lailaksiri … Worawalun Honglertnapakul

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OphthalmologyCohort study

Congenital superior oblique palsy was linked to much higher odds of needing surgery

Superior Oblique Palsy: Characteristics and Treatment Outcomes.

Sanpaporn Uttamapinan … Worawalun Honglertnapakul

Journal of binocular vision and ocular motility · 2026

Purpose

To evaluate the characteristics, prognostic factors, and treatment outcomes in patients with superior oblique (superior oblique) palsy.

Methods

A retrospective review was conducted on patients diagnosed with superior oblique palsy at King Chulalongkorn Memorial Hospital from January 2012 to October 2022.

n = 57 patients

Results

congenital cases were far more likely to need eye-muscle surgery

OR 30 (95% CI 3.55 to 253.86)

CI excludes the null - significant

More results

Among 57 patients, 43 (75.4%) had acquired superior oblique palsy, most commonly due to ischemia (50.9%).

Unilateral involvement was observed in 48 patients (84.2%), while 9 (15.8%) had bilateral superior oblique palsy.

Among 26 surgeries, inferior oblique (inferior oblique) myectomy was the most common (57.7%).

More results

Motor and sensory successes were achieved in 84.6% and 50% of cases respectively.

“

Conclusion · 1 of 4

Superior oblique palsy management requires individualized treatment. Congenital cases were more likely to require surgery.

Conclusion · 2 of 4

inferior oblique myectomy is effective for vertical deviations ≤15 PD, while larger misalignments need combined procedures.

Conclusion · 3 of 4

The Harada-Ito procedure corrected 10 (7.5-11) degrees of extorsion for each operated eye in bilateral superior oblique palsy.

Conclusion · 4 of 4

Aiming for early small residual hypertropia is advisable due to postoperative drift to overcorrection, particularly in congenital cases with large fusional amplitudes.

Post

Superior Oblique Palsy: Characteristics and Treatment Outcomes.

Congenital superior oblique palsy was linked to much higher odds of needing surgery

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