Dr.DEVIKA SAXENA

PROF.DR. RAMAN YENUGANDULA

Abstract

Purpose :To report a child with post traumatic 4th cranial nerve palsy and treatment outcomes with Parks procedure.

Method: Child of 7 years age presented to paediatric ophthalmology OPD, informant mother complained that child suffered with double vision and abnormal head tilt to left shoulder following an injury with cycle pedal to her head. On orthoptic evaluation, findings were compensatory head posture to left, head tilt, right eye hypertropia. Ocular motility showed hypertropia; increased on left gaze and Bielschwosky head tilt test confirmed right eye superior oblique palsy. MRI scan with contrast is within normal limits. After a waiting period of 8 months, the case was taken for Parks graded Inferior oblique recession, which then resulted in the resolution of diplopia and compensatory head posture.

Result : Parks procedure is successful in treating acquired 4th nerve palsy.