Whitnall’s (superior transverse) ligament and the superior oblique tendon in the trochlea have common fascial attachments at the orbital rim (Figure 43). If the superior transverse ligament is weakened inadvertently while hooking the superior oblique tendon, thereby weakening the medial horn of the levator muscle, ptosis of the nasal portion of the upper lid usually results. Therefore, it is safer to hook the superior oblique tendon under direct vision. This can be done between the nasal border of the superior rectus and the trochlea or an even safer place is at the insertion. Whitnall’s ligament acts as a clothesline, suspending the levator aponeurosis and the medial portion of the superior oblique tendon.