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Documenta Ophthalmologica

, Volume 34, Issue 1, pp 123–136 | Cite as

True and simulated superior oblique tendon sheath syndromes

  • Harold Whaley Brown
Article

Conclusions

The following conclusions can be drawn from this discussion concerning the true and simulated superior oblique tendon sheath syndromes :
  1. 1.

    Apparently there is a higher incidence of the sheath syndrome in females than in males and a higher incidence of involvement of the right eye than in the left eye.

     
  2. 2.

    Approximately 10% of the 126 cases are bilateral.

     
  3. 3.

    The clinical features of the true sheath syndromes are simulated by anomalies other than a congenital short anterior sheath of the superior oblique tendon in at least 20% of the sheath syndrome cases. There is reason to believe that the incidence of the simulated sheath syndrome is higher than 20%.

     
  4. 4.

    The true sheath syndrome is due to a primary congenital structural anomaly involving the anterior sheath of the superior oblique tendon.

     
  5. 5.

    The simulated sheath syndrome is due to a congenital structural anomaly involving the posterior tendon or to an abnormal firm attachment of the sheath to the posterior tendon or both. Either a thick area in the posterior tendon or firm attachments of the sheath to the posterior tendon can offer some resistance to the forward movement of the tendon through the trochlea. The abnormal firm attachments of the sheath to the posterior tendon occurs probably more frequently than a thickened area in the posterior tendon.

     
  6. 6.

    A positive traction test in congenital cases, at the present time, can be considered pathognomonic for a true sheath syndrome.

     
  7. 7.

    Acquired and intermittent simulated sheath syndromes are of inflammatory origin.

     
  8. 8.

    An operation is not indicated in the absence of a disfiguring head tilt or a vertical tropia.

     

Keywords

Public Health Forward Movement Tendon Sheath Head Tilt Structural Anomaly 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. adler, f. H. Spontaneous Recovery in a Case of Superior Oblique Sheath Syndrome of Brown, Arch. Ophth. 61: 1006 (1959).Google Scholar
  2. berke, r. N. Tenotomy of the Superior Oblique for Hypertropia (preliminary report) Tr. Am. Ophth. Soc. 44: 304 (1946).Google Scholar
  3. breinin, g. M. New Aspects of Ophthalmoneurologic Diagnosis, Arch. Ophth. 58: 375 (1959).Google Scholar
  4. breinin, G. M. In Strabismus Symposium of the New Orleans Academy of Ophthalmology (Haik, G. M. ed), C. V. Mosby Co. p. 345 (1962).Google Scholar
  5. brown, h. W. Congenital Structural Muscle Anomalies: In Strabismus Ophthalmic Symposium. (Allen, J. H. ed), C. V. Mosby Co., St. Louis p. 205 (1950).Google Scholar
  6. — Isolated Inferior Oblique Paralysis, Tr. Am. Ophth. Soc. 55: 415 (1957).Google Scholar
  7. brown, H. W. Strabismus in the Adult, In Strabismus Symposium of New Orleans Academy of Ophth. (Haik, G.M., ed) C. V. Mosby Co. p. 248 (1962).Google Scholar
  8. clark, e. a. Case of Apparent Intermittent Overaction of the Left Superior Oblique, Brit. Orthoptic J. 21: 116 (1966).Google Scholar
  9. costenbader, f. d. & g. a.dan. Spontaneous Regression of Pseudoparalysis of the Inferior Oblique Muscle, Arch. Ophth. 59: 607 (1958).Google Scholar
  10. duane, a. Congenital Deviations of the Eyes, Tr. Am. Ophth. Soc. 12: 994 (1909).Google Scholar
  11. dyer, j. a. Superior Oblique Sheath Syndrome, Ann. Ophth. 2: 790 (1970).Google Scholar
  12. féric-seiwerth, f. In: Report on the 2nd International Orthoptic Congress in Amsterdam, May 11, 1971, in the International Strabismological Association Newsletter No. 10, November, 1971 (Peter Fells ed.), p. 7.Google Scholar
  13. folk, e. R. Superior Oblique Tendon Sheath Syndrome, Arch. Ophth. 57: 39 (1957).Google Scholar
  14. girard, l. j. Pseudoparalysis of the Inferior Oblique Muscle, South M.J. 49: 342 (1956).Google Scholar
  15. goel, b. & r. Gogi. Tendon Sheath Syndrome, Orient. Arch. Ophth. November, 1968, p. 302.Google Scholar
  16. goldstein, j. H. Intermittent Superior Oblique Sheath Syndrome, Am. J. Ophth. 67: 960 (1969).Google Scholar
  17. gowan, m. & j.levy. Heredity in the Superior Oblique Tendon Sheath Syndrome, Brit. Orthoptic J. 25: 91 (1968).Google Scholar
  18. last, r. j. Wolff's Anatomy of the Eye and Orbit, W. B. Saunders Co. Philadelphia, p. 237 (1961).Google Scholar
  19. lowe, r. f. Bilateral Superior Oblique Tendon Sheath Syndrome, Brit. J. Ophth. 53: 466 (1969).Google Scholar
  20. lyle, k. t. & m. c.bridgemen. In Worth and Chavasse, Squint, 9th edition, Bailliere, Tidall and Cox, London 1959, p. 259.Google Scholar
  21. nutt, a. b. Observations on the Etiology and Treatment of the Vertical Congenital Ocular Palsies, Brit. Orthoptic J. 12: 4 (1955).Google Scholar
  22. phillips, W. C. Personal communication.Google Scholar
  23. rayner, j. & r. L.hiatt. Bilateral Brown's Superior Oblique Tendon Sheath Syndrome, Ann. Ophth. 5: 506 (1970).Google Scholar
  24. raynor, e. f. Superior Oblique Tendon Sheath Syndrome; a Report of a Case, Am. Orthoptic J. 6: 128 (1956).Google Scholar
  25. roper-Hall, M. J. In : Report on the 2nd International Orthoptic Congress in Amsterdam May 11, 1971 in the International Strabismological Association Newsletter No. 10, November 1971 (Peter Fells ed) p. 7.Google Scholar
  26. sanford-Smith, j. H. Intermittent Superior Oblique Tendon Sheath Syndrome, Brit. J. Ophth. 53: 412 (1969).Google Scholar
  27. urist, m. J. Head Tilt in Vertical Muscle Paresis, Am. J. Ophth. 69: 440 (1970).Google Scholar

Copyright information

© Dr. W. Junk b.v. Publishers 1973

Authors and Affiliations

  • Harold Whaley Brown
    • 1
  1. 1.New YorkUSA

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