Third Nerve Palsy
WHAT IS A THIRD NERVE PALSY or weakness?
The third cranial nerve controls how the eye moves and looks. It moves four of the six muscles. These muscles help move the eye up, down, in and around. The third nerve also helps make the pupil smaller and lift the upper eyelid. When the third nerve doesn’t work well, the eyelid might stay closed and the eye might not move well. The eye might look down and out. Also, the pupil might be big and not react to light.
WHAT ARE THE SignS OF THIRD NERVE Problem?
Older kids and adults with third nerve weakness might see double. Young children usually do not say they have double vision. A droopy eyelid might hide the double vision. A droopy eyelid or a big pupil might be the first sign of a third nerve problem. Figure 1 shows the eye looking outward underneath the droopy eyelid. Figure 2 shows the droopy eyelid.
Figure 1
Figure 2
WHAT CAUSES A THIRD NERVE PALSY or weakness?
Some kids are born with it (congenital), and the exact cause may not be known. Other people can get a third nerve palsy later in life from things like head injuries, infections, vaccines, migraines, brain tumors, aneurysms, diabetes, or high blood pressure.
WHAT PROBLEMS can a THIRD NERVE PALSY cause in kids?
Children might get blurry vision or lazy eye (amblyopia) from a third nerve weakness. Some kids do not have normal depth perception. Some children might need to tilt their head in order to see better. Some kids with a third nerve weakness can do well, it depends on how bad it is.
how can a THIRD NERVE PALSY be fixed?
If a child is born with a third nerve palsy, it can’t be fixed completely.
If it happens later in life, it might get better on its own or when the cause is treated. Doctors usually wait at least 6 months to see if it gets better.
Treatments like eye patches and special prism glasses can help with double vision.
If the problems from a third nerve palsy don’t get better, surgery can help. Eye muscle surgery can help the eye move better. Eyelid surgery can help with the eyelid drooping. Problems from a third nerve palsy are hard to fix completely. More than one surgery might be needed. Even after surgery, the eyes might not fully line up when looking up or off to the sides.
Updated 06/2024
#Conditions