Delhi Journal of Ophthalmology

Bilateral Superior Oblique Tenectomy for Exotropia with Vertical and Lateral Incomitance

Manasvini Sharma, Soveeta Rath, Suma Ganesh
Dr Shroff’s Charity Eye Hospital, New Delhi, India

Editor-in-Chief, Delhi Journal of Ophthalmology, Dr R.P.Centre, AIIMS.

Corresponding Author:

Manasvini Sharma
Fellow, Pediatric Ophthalmology, Strabismusand Neuro-ophthalmology
Dr. Shroff’s Charity Eye Hospital,
KedarnathRoad, Daryaganj,
New Delhi - 110002, India
Email id:

Received: 21-NOV-2018 Accepted: 04-FEB-2019 Published Online: 05-MAY-2019

Bilateral superior oblique overaction is usually associated with A pattern strabismus and in some cases, a compensatory head tilt can be present. We report a case of a 9 year old girl who presented to our outpatient department with complaints of outward deviation of eyes since 2 years. On examination, she had a compensatory face turn to the right. Her visual acuity was 6/6 in both eyes. Cover test showed exotropia with A pattern, lateral incomitance and an asymmetric superior oblique overaction (SOOA) in both eyes. Fundus examination showed intorsion in both eyes. Bilateral asymmetric superior oblique tenectomy was performed which corrected the compensatory head posture and incomitant exotropia along with collapse of A pattern. Hence, bilateral superior oblique tenectomy is an effective tool for SOOA presenting with A pattern.

Keywords :A pattern, Exotropia, Lateral incomitance, Superior oblique overaction, Tenectomy