Here we discuss the surgery in a 41-year-old female presented to us with a history of road traffic accident 8 months back with third nerve palsy. On recovery, she had primary deviation was 30PD exotropia / 15-20 PD L/R. Ocular motility showed -4 limitation of elevation and – 1 limitation of depression of right eye. Palpebral fissure height increased on adduction.There was mild ptosis of right eye. She was diagnosed with Right eye partially recovered third nerve palsy with aberrant regeneration.She underwent (OD)lateral rectus transposition to superior rectus with fosters augmentation, (OS) LR recession under adjustable suture 9mm (5+4) and MR plication 6mm under local anesthesia. Postoperatively at 3 months, she showed orthophoria for Distance and near in primary gaze without any ptosis. Managing the freakily recovered third nerve this way gave the perfect correction without the need for ptosis surgery.
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