Dr. Sumitha Muthu

Dr. JYOTI MATALIA, Dr.Shetty Bhujang K

Abstract

The surgical management of 3rd nerve palsy depends on age, complete or partial 3rd nerve palsy & paresis or complete paralysis of involved muscles. We describe 3 different scenarios of surgical management of 3rd nerve palsy.

A 40 year old lady presented with inferior division 3rd nerve palsy. In 1st stage adjustable transposition of SR to MR & LR to IR was done followed by MR plication LR recession in 2nd stage

A 5 year old child who presented with -6 adduction (95 PD XT), underwent split transposition of LR to MR with SO tenotomy.

An infant with complete 3rd nerve palsy underwent Right LR recession with asymmetric ciliary sparing transposition of vertical recti to MR with foster augmentation followed by ptosis correction.

Conclusion: Thorough evaluation is mandatory in every case of 3rd nerve palsy as the number of muscles involved, extent of involvement & contracture varies in every case. Hence, one must adopt an individualized approach for each case to achieve best outcome.