IT IS THE purpose of this paper to discuss seven years' experience with direct surgery of the underacting superior oblique muscle and eight years' experience with direct surgery of the weak inferior oblique muscle. Although the long-standing fear of oblique muscle surgery was gradually yielding to successful demonstrations of weakening operations on the inferior oblique muscle, it remained for Wheeler,1 in 1935, to show that surgical correction of the superior oblique could be performed and that the underacting inferior oblique could be strengthened. Before his paper, and even after it, attempts to compensate for pareses of the oblique muscles were usually made on the vertical rectus muscles, if at all.2 The influence of von Graefe's3 frequently quoted interdiction of direct surgery of the oblique muscles was still strong.
The anatomy and physiology of the oblique muscles have been so adequately reviewed and discussed, especially in the recent
McLEAN JM. DIRECT SURGERY OF PARETIC OBLIQUE MUSCLES. Arch Ophthalmol. 1949;42(1):50-65. doi:10.1001/archopht.1949.00900050053005