How is superior oblique palsy?
Once the cause of an acquired superior oblique palsy has been treated, it is usual to wait 6 months for the palsy to resolve spontaneously. While awaiting spontaneous resolution, diplopia can be managed with prism glasses. Prisms merge two images into one but do not strengthen the eye muscles. If prism is not effective a patch or covering one eye can alleviate the double vision. The treatment of choice for congenital superior oblique palsy and unresolved (after 6 months) acquired palsy is typically eye muscle surgery. Surgery often minimizes double vision, reduces the unsightly upward drift of an eye and corrects a compensatory head tilt. Surgery is performed on one or both eyes depending on the extent of the eye misalignment, the change of the misalignment in different directions of gaze, the amount of head tilt and the amount of torsion.
