Superior Oblique Palsy: Characteristics and Treatment Outcomes.

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

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

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

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