Dr. Sumitha Muthu

, Dr. JYOTI MATALIA, Dr. VASUDHA KEMMANU, Dr. ROHIT SHETTY

Abstract

The surgical management of third nerve palsy depends on the age, whether it is a complete or partial 3rd nerve palsy. We describe 3 different scenarios of surgical management of 3rd nerve palsy – One acquired & two congenital.

A 40 year old lady presented with inferior division third nerve palsy. In the 1st stage adjustable transposition of SR to MR and LR to IR was done followed by MR plication in 2nd stage.

A 5 year old child presented with large left face turn and congenital 3rd nerve palsy. Child underwent split transposition of LR to MR with SO tenotomy

An 18 month old baby presented with complete 3rd nerve palsy with ptosis. Considering the dense amblyopia, she underwent right LR recession with asymmetric ciliary sparing transposition of vertical recti (1/3rd SR and 2/3rd IR transposition) to MR with foster augmentation followed by ptosis correction after 1 month.

An individualized approach was chosen for each case which resulted in excellent ocular alignment