Direct trauma to the superior oblique tendon following penetrating injuries of the upper eyelid.

We report two cases of direct trauma to the superior oblique tendon after penetrating injury of the upper eyelid with hook-shaped tools. Both patients originally presented with a Knapp type VII superior oblique palsy, but one patient severed the superior oblique tendon proximal to the trochlea, whereas the other patient engaged the distal reflected segment of the tendon with the hook and pulled it forward into the upper eyelid.