Adjustable anterior and nasal transposition of inferior oblique muscle in case of Torsional Diplopia in Superior Oblique Palsy

Superior oblique palsy presents with a vertical and torsional deviation and diplopia which is often exacerbated by an ipsilateral inferior oblique over action. The usual surgical approach is defined by the extent of inferior oblique over action and/or vertical deviation and includes weakening of the ipsilateral inferior oblique muscle. If torsional diplopia outweighs the vertical component then, an antero-nasal transposition of the inferior oblique may be undertaken to correct both. We describe a novel surgical technique for adjustable antero-nasal transposition of the inferior oblique muscle for a residual torsional diplopia in one case of a superior oblique palsy.