title: Botulinum toxin injection of the inferior oblique muscle for the treatment of superior oblique muscle palsy.
abstract: OBJECTIVE
  To evaluate botulinum toxin injection of the inferior oblique muscle for management of superior oblique (SO) paresis.
  
  
  METHODS
  We undertook a prospective case series of injections of the ipsilateral inferior oblique (IO) muscle with 10-20 units of botulinum toxin type A in patients with a SO muscle palsy/paresis of less than 2 years' duration.
  
  
  RESULTS
  We enrolled 16 patients (18 eyes) with a mean age of 33.7 years. The median time from onset of symptoms until injection was 6 months. The cause of paresis was trauma for 81% of the patients. The mean hypertropia decreased from 6.4(Delta) to 1.9(Delta) at 6 months after treatment. Other clinical measures improved: mean IO overaction from + 1.7 to + 0.6, mean SO underaction from -1.5 to -0.4, mean subjective torsion from 9.3 degrees to 0.4 degrees , and mean head tilt from 8.4 degrees to 1.1 degrees.
  
  
  CONCLUSIONS
  Botulinum toxin injection to IO muscle reduces the symptoms of SO paresis while patients are waiting for recovery.
authors.affiliation: Department of Ophthalmology, Labbafinejad Hospital, Shahid Beheshti University, Ophthalmic Research Center, Tehran, Iran. abbasbagheri@yahoo.com
authors.forename: Abbas
authors.initials: A
authors.lastname: Bagheri
authors.forename: Mohammad
authors.initials: M
authors.lastname: Eshaghi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002648:Child; D004172:Diplopia / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D009801:Oculomotor Muscles / Q000187:drug effects*; D011446:Prospective Studies; D013285:Strabismus / Q000188:drug therapy*; D016896:Treatment Outcome; D020432:Trochlear Nerve Diseases / Q000188:drug therapy*; D015348:Vision, Binocular
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A