A 3-year-old boy with congenital esotropia and underaction of both superior obliques developed a marked left head tilt that was not relieved by weakening the right inferior oblique. On attempted right superior oblique tuck, no superior oblique could be found. Alternately, a new procedure for intorsion of the right eye was performed, consisting of a temporal shift of the right superior rectus and a nasal shift of the right inferior rectus. The results are cosmetically acceptable for both the eye position and the head tilt.
Mumma JV. Surgical Procedure for Congenital Absence of the Superior Oblique. Arch Ophthalmol. 1974;92(3):221-223. doi:10.1001/archopht.1974.01010010229010