title: The relationship between duration of superior oblique palsy and vertical fusional vergence, cyclodeviation, and diplopia.
abstract: BACKGROUND
  The purpose of this study was to explore the relationship between the duration of superior oblique palsy (SOP) and relevant clinical findings.
  
  
  METHODS
  We studied 39 patients with SOP and 14 patients with normal binocular vision (NBV). Vertical fusional vergences and cyclodeviations were measured through the habitual prescription. Each patient was asked if he or she currently experienced diplopia. To establish duration of SOP, those patients were asked and grouped according to whether they were diagnosed within the past 5 years, within the past 6 to 15 years, or more than 15 years ago.
  
  
  RESULTS
  The SOP patients were significantly different from the NBV patients on every measure except the infra recovery value. Among the SOP patients, the infra break value and the total break amplitude (infra plus supra) were the measures that were significantly different for the three SOP groups, increasing with the duration of the deviation. Since the infra break value was measured relative to any corrective prism in place, the total break amplitude proved to be the best distinguishing feature of duration of the SOP. There was no monotonic relation between the duration and the magnitude of the cyclodeviation. Likewise, there was no significant difference among the SOP groups in the frequency of reported diplopia even though there was a monotonic decrease in the percentage of diplopic patients with increasing duration of SOP.
  
  
  CONCLUSIONS
  While an increased vergence amplitude and the presence of both diplopia and excyclodeviation distinguish patients with SOP from those with NBV, the total break amplitude is the only significant distinguishing feature of the duration of SOP.
authors.affiliation: School of Optometry, University of Alabama at Birmingham 35294-0010, USA.
authors.forename: R P
authors.initials: RP
authors.lastname: Rutstein
authors.forename: D A
authors.initials: DA
authors.lastname: Corliss
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003290:Convergence, Ocular; D004172:Diplopia / Q000503:physiopathology*; D005133:Eye Movements; D006801:Humans; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000503:physiopathology*; D009886:Ophthalmoplegia / Q000503:physiopathology*; D015348:Vision, Binocular