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Eye Care Archive (Expert Forum)
IV Nerve Palsy and Hypotropia in child
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
IV Nerve Palsy and Hypotropia in child
by larap, Mar 09, 2007 12:00AM
My 15 month old son presented with a severe right head tilt when he was about 5-6 months old. He was initially diagnosed with Muscular Torticollis and received Occupational Therapy for several months. He also had an MRI and CT to rule out neurological disorders. He was not a typical torticollis case because his head was not "stuck" inthat position and his right SCM was not tight or shorter than the other. Through research of my own I found about IV Nerve Palsy and went to a Pediatric Opthamologist. He confirmed this diagnosis and performed a tuck of the left Superior Oblique and a recession of the left Inferior Oblique. After the surgery my son held is head up straight for about 2 weeks and then it started leaning toward the other side! His eyes also appeared to be misalligned; his left eye was hypotrophic. The doctor said that it was a possible overcorrection so they operated again and removed the tuck. Since this surgery there has still been no improvement. The doctor says that there could be a IV Nerve Palsy in the other eye that couldn't be seen until his left eye was corrected, but that does not explain the left hypotropia. Should I get a second opinion? What could be causing the left hypotropia? I am very concerned since this is such an important period of development. Help!!
Doctor's Answer
by Forum-OD-MP, Mar 09, 2007 12:00AM
a second opinion is never, ever a bad idea. most patients are hesitant to get one a lot of the time however b/c of cost. most second opinions are not paid for by your health care. it would likely be an out of pocket expense.
but yes, you probably need a second opinion. and many things could be causing the left hypotropia. not going to be easy to figure out.
but yes, you probably need a second opinion. and many things could be causing the left hypotropia. not going to be easy to figure out.
