Proximal and Distal Click Syndrome of the Superior
Oblique Tendon (Simulated Superior Oblique
Tendon Syndrome) 525h77f 525h77f 525h77f 525h77f 525h77f 525h77f
General: Produced by quick head movements; caused by adhesions (secondary to trauma and inflammation) or frontal sinus surgery; proximal click adhesions in front to trochlea; distal click adhesions behind trochlea; associated with Brown syndrome.
Ocular: Decreased elevation in adduction; downshoot of the affected eye on adduction; overaction of the tethered inferior oblique after cutting superior oblique tendon; widening of palpebral fissure on adduction; diplopia.
Clinical: Rheumatoid arthritis.
Brown HW. True and simulated superior oblique tendon sheath syndromes. Doc Ophthalmol 1973; 34:123-l36.
Pittke EC. The proximal and distal click syndrome of the superior oblique tendon. Graefes Arch Clin Exp Ophthalmol 1987; 225:28-32.
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