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Introduction: Superior oblique palsy (SOP) is the most common cause of paralytic strabismus. Therefore, this study aimed to compare the frequency, etiology and outcome of surgical approaches in SOP with other vertical strabismus. Methods: This is a cross sectional study that was performed on 303 medical files of patients who referred to Yazd eye clinic from 1999-2012 with at least 6 months post operative follow up. The study instrument involved a questionnaire containing 11 questions that was used for data gathering. Results: In this study, within 303 patients, 50 cases (16/5%) suffered from SOP (group A) and 253 cases from other vertical strabismus (group B).The most frequent causes of either group were congenital and trauma. The mean age of patients with congenital cause was 16/82 in group A and 12/81 years in group B while the mean age with traumatic cause was 24/63 in group A and 23/26 years in group B. Sixty percent (60%) of operated patients in group A underwent one set of surgery while in group B mostly had two sets of the surgery. The most common surgical approach in either group was IO Recession. The rate of strabismus correction was 71/5% in group A and 77/8% in group B. SCH, diplopia, conjunctivitis were the most frequent complications in either group. Conclusion: By one set surgical approach of IO Recession, strabismus correction is observed in the most patients with SOP or other vertical strabismus and the surgery was not followed by severe complications.

Keywords: Congenital; IO Recession; Superior oblique palsy; Traumatic; Vertical strabismus

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