This paper reports two cases with anomalous posterior course of the superior oblique tendon with insertion nasal to the superior rectus tendon. Both presented with Brown syndrome-like clinical scenarios. The cases were a five-year-old female and four-year-old male. Diagnosis was made during surgery for strabismus and ocular motility pattern. The defect was classed as sagittalisation. The authors postulate the abnormal insertion restricts elevation in abduction and creates a tethering effect similar to that seen in Brown syndrome. Corrective surgery involved lengthening of the superior oblique and both children had improved strabismus and ocular motility postoperatively.
Superior oblique sagittalisation
Reviewed by Fiona Rowe
Nasal insertion of the superior oblique tendon presenting as Brown syndrome.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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