Superior Oblique Procedures HongVan Le, MD SUPERIOR OBLIQUE MUSCLE The superior oblique (SO) intorts, depresses, and abducts the eye (see Chapter 42). Patients with a SO palsy will typically demonstrate…

Inferior Oblique Procedures Yasmin Poustchi Mali, MD WEAKENING OF THE INFERIOR OBLIQUE: MYECTOMY, RECESSION, ANTERIORIZATION, AND EXTIRPATION Preoperative Considerations Unilateral superior oblique palsy: Perform preoperative strabismus measurements and intraoperative forced…

Strengthening Rectus Muscles Jagger C. Koerner, MD, MBA INTRODUCTION There are four procedures to strengthen a rectus muscle: resection, plication (“muscle tuck”), advancement, and injection of bupivacaine (see Chapter 55)….

Weakening Rectus Muscles Megan X. Law, MD PREOPERATIVE CONSIDERATIONS Recessions move the muscle insertion to a new location closer to its origin to weaken the effect of the muscle. There…

Conjunctival Incisions and Muscle Isolation Tanya Glaser, MD PREOPERATIVE CONSIDERATIONS All strabismus surgery requires an incision through the conjunctiva and Tenon capsule to allow access to the extraocular muscles in…

The Basics Lucas Bonafede, MD ANATOMY1,2 (FIG. 42.1) All the extraocular muscles except the inferior oblique muscle originate from the orbital apex. The inferior oblique muscle originates from the anterior…

Pediatric Ptosis Repair: Muller Muscle Conjunctival Resection Paramjit K. Bhullar, MD Jason A. Liss, MD PREOPERATIVE CONSIDERATIONS Select Appropriate Patients Muller muscle conjunctival resection is uncommonly performed in children. Procedure…

Pediatric Ptosis Repair: Blepharophimosis Syndrome Michael J. Richard, MD Blepharophimosis syndrome is a rare disorder either inherited as an autosomal dominant trait or occurring sporadically. The major findings of the…

Pediatric Ptosis Repair: Levator Resection Meghan S. Flemmons, MD PREOPERATIVE CONSIDERATIONS Levator resection may be performed if there is fair to good levator function. This is determined by measuring upper…

Pediatric Ptosis Repair: Frontalis Suspension Roshni Ranjit-Reeves, MD Frontalis suspension is the procedure of choice for patients with significant ptosis with poor levator function (Fig. 38.1). Often, it is performed…