Fig. 15. A Jameson hook is placed beneath the superior rectus muscle through a superior temporal fornix incision. The conjunctiva and Tenon's capsule are reflected over the superior rectus insertion with a Stevens hook. This maneuver exposes the distal superior rectus muscle, with its adherent broad sheet like check ligament fusing to its superior surface diagonally 8 to 12 mm posterior to its insertion. The ligament is opened centrally at its insertion on the surface of the superior rectus muscle with blunt Westcott scissors.