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    By Ramesh Murthy, MBBS
    Pediatric Ophth/Strabismus

    Superior oblique tendon weakening procedures are indicated for the management of superior oblique overaction, inferior oblique palsy and Brown's syndrome. Uncontrolled lengthening procedures like tenotomy carry a high risk of superior oblique palsy. Controlled superior oblique tendon lengthening can be performed by a Wright silicone tendon expander without causing nerve palsy. In this video we demonstrate a simple technique of graded weakening of the superior oblique by inserting a segment of silicone 240 retinal band between the cut ends of the tendon. With careful attention to detail, one can achieve predictable results with this technique.