Congenital superior oblique palsy in infants.

A retrospective review of 20 cases of infants with congenital superior oblique palsy showed that all cases had been diagnosed and treated surgically before the patient was 2 years old. Single inferior oblique weakening procedures, single superior oblique tucks, and combined inferior oblique weakening procedures and superior oblique tucks were performed as the initial surgical procedures. Best results were obtained with the two-muscle procedure. The presence of preoperative primary position hypertropia correlated significantly with failure of single inferior oblique weakening to eliminate the signs of superior oblique palsy.