Anterior transposition of the inferior oblique muscle as the initial treatment of a snapped inferior rectus muscle

Snapping or tearing of an extraocular muscle refers to its rupture across i ts width, usually at the junction between muscle and tendon several millime ters behind the insertion. Tearing occurs during strabismus or retinal reat tachment surgery, or after trauma.(1) If the proximal end of the muscle can not be located, transposition procedures are necessary to achieve ocular re alignment. These surgical procedures carry the risk of anterior segment isc hemia, especially in the elderly.(1-4) Anterior transposition of the inferi or oblique muscle has been used for the treatment of inferior oblique overa ction, especially in the presence of a dissociated vertical deviation, and in patients with fourth nerve palsy.(5,6) We transposed the inferior obliqu e muscle insertion in a 73-year-old woman with a snapped inferior rectus mu scle.