How sensitive is the three-step test in the diagnosis of superior oblique palsy?

2013 ◽  
Vol 17 (1) ◽  
pp. e7
Author(s):  
Ajay M. Manchandia ◽  
Joseph L. Demer
Keyword(s):  
Step Test ◽  
Superior Oblique Palsy ◽  
Superior Oblique

scholarly journals Idiopathic Isolated Acquired Steroid Dependent SO Palsy: A Rare Case Report

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Isha Agarwal ◽  
Mayuresh Naik ◽  
HarinderSingh Sethi
Keyword(s):  
Body Weight ◽  
Oral Prednisolone ◽  
Final Diagnosis ◽  
Sudden Onset ◽  
Step Test ◽  
Superior Oblique Palsy ◽  
Steroid Dependent ◽  
Rare Case Report ◽  
Oral Steroids ◽  
Superior Oblique

15-year-old boy presented with sudden onset, stable, nonprogressive painless diplopia (greatest in right gaze and inferior field of view) and hyperdeviation of left eye for a year. On ophthalmic examination, the patient had uncrossed diplopia with tilt and separation maximum in dextrodepression. On Park’s three step test, left eye hypertropia increased on right gaze and left tilt suggestive of left superior oblique (SO) palsy. On prism bar cover test (PBCT), deviation was more than 25 PD base-down over the left eye for both distance and near in all gazes. MRI head and orbit revealed a normal study while the myasthenia and inflammatory work-up was unremarkable. A provisional diagnosis of “Idiopathic Acquired Left Superior Oblique Palsy” was made and the patient was given trial of oral steroids at 1 mg/kg body weight. At 6 weeks, patient’s diplopia resolved and PBCT neutralised at 6PD. Oral steroids were gradually tapered off by 10 mg per week with weekly follow-up. Upon decreasing the dose of prednisolone to 5 mg, intermittent diplopia and 18 PD left hypertropia reappeared. When patient was again restarted on oral steroids at 1 mg/kg body weight, diplopia-hypertropia disappeared at 10 mg OD prednisolone only to reappear at 5 mg OD dosage, leading to the final diagnosis of a “Steroid Dependent Isolated Superior Oblique Palsy”. Presently, the patient is maintained on a daily dose of 10 mg oral prednisolone.

scholarly journals Pseudoamblyopia in Congenital Cyclotropia

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Antonio Frattolillo ◽  
Filippo Tassi ◽  
Valentina Di Croce ◽  
Costantino Schiavi
Keyword(s):  
Visual Acuity ◽  
Surgical Correction ◽  
Visual Performance ◽  
Time Study ◽  
Superior Oblique Palsy ◽  
Fixation Pattern ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity ◽  
Superior Oblique

Purpose. To study the effect of surgery on amblyopia and suppression associated with congenital cyclovertical strabismus. Methods. The fixation pattern was investigated with microperimetry before and soon after surgery in ten consecutive children operated for congenital superior oblique palsy at the S. Martino Hospital, Belluno, Italy, between September 2014 and December 2015. Changes in visual performance in terms of best-corrected visual acuity (BCVA) and stereopsis between the day before and one week after surgery were also evaluated. No other amblyopia treatment has been administered during the time study. Results. Surgical correction of the excyclodeviation in congenital SO palsy determined monocular and binocular sensory consequences: monocularly, in the cyclodeviated amblyopic eye, BCVA (0.46–0.03 LogMAR; p<0.0001) and the fixation pattern improved, as demonstrated by microperimetry examination. Binocularly, stereopsis improved or emerged while suppression at the Worth four-dot test disappeared. Conclusions. In the absence of further amblyopic factors such as coexisting constant vertical and/or horizontal deviation and anisometropia, the amblyopia encountered in congenital SO palsy may resolve soon after the surgical alignment. Therefore, it may be considered and defined “pseudoamblyopia.”

Cyclofusion in Normal and Superior Oblique Palsy Subjects

1999 ◽  
Vol 36 (5) ◽  
pp. 264-270
Author(s):  
Pradeep Sharma ◽  
Krishna Prasad ◽  
Sudarshan Khokhar
Keyword(s):  
Superior Oblique Palsy ◽  
Superior Oblique

A Combined Surgical Approach to Bilateral Superior Oblique Palsy

1982 ◽  
Vol 13 (12) ◽  
pp. 1000-1003
Author(s):  
Barry S Pinchoff ◽  
Terry J Bergstrom ◽  
Gary S Sandall
Keyword(s):  
Surgical Approach ◽  
Superior Oblique Palsy ◽  
Superior Oblique
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