DR. ANITA GANGER

DR.SHASHI NATH JHA, DR.UKALKAR MADHURA SANJAY

Abstract

PURPOSE: The surgical correction of large angle deviation in the oculomotor nerve palsy is a formidable challenge for a strabismologist. Several staged procedures are required to achieve an optimal correction. METHODS: 56 old female presented with double vission since 10 days. O/E right eye had limitation of movements in all gazes except abduction and intorsion was intact. Pupil was mid dilated so diagnosis of complete third nerve palsy (Ischaemic etiology) was made after ruling out all other etiological causes. First stage Supramaximal MR resection and lateral rectus (LR) recession was done resulted in horizontal eye alignment with residual hypertropia. Second stage surgery of ipsilateral inferior oblique recession and contralateral inferior rectus recession 4.5 mm was done. RESULTS: Second surgery resulted in optimal eye alignment with diplopia free primary gaze. CONCLUSION: Ophthalmic nerve palsies management should be customized as per individual patient.