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6th nerve palsy
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6th nerve palsy

I have developed 6th nerve palsy (diagnosed by my surgeon) after pituitary tumor removal.  Apparently one of the 2 tumors on my gland was up against the 6th nerve.  I was assured that the nerve was not damaged.  My left eye is crossed.  It moves up and down and to the right but it will not go left at all.  Is there something I can do to help it heal faster?  Should I patch it or try to use it more often?  Should this return to normal?  I'm having a very hard time with this.  I cannot drive and it looks ridiculous.  At the end of the day it is also sore.  Is this normal?

Thanks for any replies.
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I'm sorry.  It means the nerve was either irritated or damaged during the surgery which is not uncommon.  There is really nothing you can do but wait and hope that it comes back to function (that it was not significantly damaged).  This may take up to six months but usually you start to see improvement within the first couple of months if it is going to happen.  You may patch the eye if you have double vision that interferes with your vision but whether you patch or not should not affect the outcome.  You should also make sure your ophthalmologist does a visual field test on both eyes to see if there are any defects.  Hang in there.

HV
31 Comments
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Avatar_m_tn
Thank you for your quick reply...I really appreciate it. I did receive an MRI the night after my surgery and the dr says my nerve looks fine and assured me it was not damaged, just "pissed off at the drs for irritating it" (Drs words exactly, haha).  The last few days my eye feels sore.  Is this normal?  Is this a sign, maybe, that it is beginning to have feeling or whatever back?  Is it a spontaneous recovery or gradual?  It will be 4 weeks this Friday that I had the surgery.  I was told to wait it out for 3 months and then my dr will refer me to a neuro-opthomaligist.

Thanks again.
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1573381_tn?1296151159
It usually is a gradual recovery.  Not sure about it being sore so go get an eye exam to make sure the eye is OK.  Wait it out as the dr says as nothing that could really be done to speed it up.

HV
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Avatar_n_tn
HI I to have 6th nerve palsy. Mine will be nearly four weeks soon. Mine came on after a lumbar puncture. I wear a prism on my glasses, it only helps me to see around the house. I wear a patch under sun glasses when out, and just started to drive short journeys yesterday. It is a real pain and is getting me down. I have been to Drs, consulatants, opticians. All with same answers, WAIT! I too have pain at the end of the day, I too feel it is part of the recovery. I have been told that nobody will even think of treating me before 6 months. I have done and tried everything in my power to get my eye right. Nothing works! I have started to take eye vitamins all full of b12s that so say help optical nerve. I am at the point that I will try anything! I did fully patch the bad eye after a week of having the palsy, I found I made it worse. Love to hear back from you, claire :-)
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Avatar_m_tn
I am so happy you found me on here!!!  I haven't heard from one single person that had this happen to them.  My surgery was 4 weeks ago yesterday (March 18).  I am also taking extra B vitamins along with a multi everyday.....NO CHANGE!!  I am seeing a neuro-opthamlogist on May 9.  Hopefully I will not HAVE to see him then, but it seems like I will unfortunately.  Please keep me updated with how your progress and I will do the same.  Even though I hate this, I am glad we can throw things off each other and be supportive.  Anything that helps us get through this!!
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Avatar_n_tn
Hi, Yes it is good that I have found somebody with this pain in the ... illness!
I have been out all day today, that means I have had a patch on under my sun glasses. So now I am in pain, so please do not worry about the pain in your eye. I have been told this is normal. How is the sight in your eye? are you seeing double? have you been given glasses? prisms?
I woke this morning and managed to put make up on and do hair, without shutting one eye this is an improvement for me. Like you I am waiting an eye hospital appointment, I just know they will not do anything and that makes me feel defeated. I am 33 single mum of 3 one of my children has a disability. I need my eye back to cope! I have started driving again, because I have to. School to far away and my baby needs to attend hospital alot. I do not like it, but it is not to bad. I tried spiritual healing toaday! I will let you know if anything happens. Like you I am sooo stressed out, and that voice in my head keeps saying MONTHS and not Days!
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Avatar_m_tn
Hello....To answer your questions, the sight in my eye is fine as far ar clarity.  I do have double vision but if I close either eye, my vision is fine.  I have not been to an eye doctor yet so I do not have glasses.  I actually gave up putting makeup on my "bad eye".  I figure, no one sees it!!  Maybe one good thing---I'm saving a bit of money on makeup.  That's stretching it a bit, but gotta find something positive in this :).  I haven't gotten the nerve up to drive so my hubby just takes me wherever I want to go.  It's like that movie "Driving Ms Daisy" only in my house it's "Driving Ms Debi".  Luckily for me my kids are both away at college so I do not have little ones at home.  However, I run a daycare out of my home so I do have to deal with them. They don't even seem to notice my crossed eye. I keep the patch off at home.  It's around my neck all day in case the door bell rings, etc.  No one except family has seen me without it.  I'm very self concious of it, I think I look ridiculous.  I have seen absolutely no improvement at all.  The only thing that I'm hoping is a good thing is the soreness I now feel. I keep telling myself "that's the nerve starting to feel again"  I have no idea if that is true, but it makes me feel better.

Like you, I am running out of patience.  But, there's nothing else to do.  I forgot what it was like to just see normal.  I had pain from my pituitary tumor for 2 1/2 years...everyday pain!!  From the moment I woke up from surgery I have had absolutely NO PAIN.  I am very grateful for that, but why something new like this???? UGH!!!!!  One day, I will get my life back.....I have to believe that.
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Avatar_n_tn
Oh Debi please do not patch the eye!!!! I have been told not to do this, when I did, mine got worse not better. It makes the eye lazy, you need to be using it to trick the brain into seeing! then with time double vision stops and hopefuly the eye turns back. I have been trying exercises, it seems to be working. Sit infront of an object, stare at it sway your head side to side, trick is to lean the bad eye to the way it wont turn. Also cover up the good eye look in mirror soon you will find bad eye turns straight, this is apparently good for getting muscle to work again. Like I said im trying anything!!! I am seeing a slight improvement this week :-)
I have give up with people looking now, I just stop and stare back!!
Mine looks silly because when you have prism on your glasses it magnifies my eye!
I can not believe you have been left with no help until you see the hospital. I still have not seen a othamologist at the hospital. But I have been going to an optician, who helps and gave me the prisms. He also can see if there has been an improvement or not. Like you im keeping positive and like to think, this is only going to be for a short while now!!!!!!!!!!!!!!
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Avatar_m_tn
Sorry, I didn't mean for you to think I patch my eye.  I meant no one sees me because I work out of my home with daycare kids, and they don't even seem to notice.  The only time I put the patch on is when I open the door for the parents of the kids.  Maybe 5 minutes at a time, a couple times a day.  Other than that, I just have my patch around my neck for easy access if the doorbell does ring.  The patch is off 99% of my day.  

I have done the same thing, looking in the mirror and "trying" to look the way my eye doesn't want to look.  I do this several times a day.  What kind of improvements are you noticing?  I think I may call an optician today and see if I can get in to see them earlier.  

I'm so glad you are seeing improvement!!  Must feel so good.  Like there may really be a light at the end of the tunnel.  I think mine may take a bit longer.  One of the pituitary tumors was right up against the 6th nerve and, although they claim it was not damaged, it was irritated.  It just needs to heal....that's what I'm being told.  One day at a time, I guess.  I keep having dreams that I wake up and it's normal, so we'll see.  In those dreams I do look the age I am now so that's promising ;)
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Avatar_n_tn
Oh good! about the patch. I was told by a doctor to patch mine up, I did for four days solid, all it did was take me backwards :-(
I am now noticing that I can see further without it seeing double. I can now focus on the tv. My eye lid is now gone back to normal and feels tighter. Small steps but, this makes me happy just to think that it is improving and not getting worse. Also my eye has started to turn back to the left only a little. Haha I took photo of myself to see if I could look that way, madness!
Yes go to a local optician in the mean time, they will help you.
I feel like I am tempting fate, when I say I have a bit of improvment. I have been told that recovery 3weeks to 6 months and in some cases it never improves. And in some people it goes and then returns :-(
If I knew that a lumbar puncture could do this much damage, I would of never agreed to have it done.They say mine was just irritated as my brain dropped onto the nerve causing pressure to it. Your dreams sound promising,we need anything to cling on to in hope for this to go away! How are you managing seeing double and with no glasses? Do you find the bad eye keeps closing when you focus?x
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Avatar_m_tn
I only had a "swollen" eyelid right after surgery.  It lasted about 3 days.  My eyelid, etc look completely normal.  The only problem, of course, is my eye is stuck looking right at my nose.  My eye still goes right and up and down but will not look left.  I do the same thing as you....try to "will" my eye to look in another direction.  It's soooo weird that no matter what, IT WILL NOT MOVE!!!  I see double but I do think my eyes are getting used to it cuz it's really not THAT bad.  It looks worse than my vision seems.  If I focus nothing changes in my bad eye.  No closing, nothing.  I spoke to the neuro opthamalogists office on Thursday and was told there are no exercises to speed up the healing, just patience.  YEA, YEA, YEA....I know!!!!!!  I couldn't squeeze in an earlier appt. so it looks like I will have to wait until May 9.  I do take a multi vitamin and an additonal B complex supplement. My endocrinolgist said B6 helps the nerves and whether it helps this, we will just have to see (pun intended :)).  But it won't hurt to take extra B, so I've been doing that for about 3 weeks.  
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Avatar_n_tn
Hi Debi, All sounds pretty much the same as mine. I am still noticing an improvement, so something i am doing is working, fingers crossed!!!!!!!!!! Heres to May 9th then :-) I still have not had my appointment through. I did go out the weekend, think my friends felt sorry for me and made me go!!!! Found the darkest club, and although I felt self conscious nobody noticed and not one comment and it was good to feel normal again :-)
Please keep me posted, I will too.
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Avatar_m_tn
I have the same problem, 6th nerve palsy. mine came on after a bad headache and nausea.  Got the headache march 2nd, eye went out of wack march 7th. was admitted to the hospital for about 12 days while they did tests everything came back negative.  8 weeks today, my eye has shown improvement, i think it has done more the last couple of weeks.  It moves past the center now and close to the right side.  I have been wearing a patch which ***** but it allows me to drive.  I did feel some twitching during the last 8 weeks couldnt pinpoint if it was my eye or eyelid.  I am hoping for a full recovery as there is not a lot of info out/on the web about this illness.  The DR.s  suspect mine may have been cause by a spontaneous CSF leak.
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Avatar_n_tn
Hi, Good know someone else with this too! Mine is 6 weeks today, the last week I have had more improvent to. I am now only wearing a patch to drive and normal glasses everywhere else. I have a appointment at the eye hospital next week, but im not expecting them to do anything. No the info on this illness is poor!!!
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Avatar_m_tn
Hi you two!!  When you say improvement, what exactly is happening?  I have not experienced any improvement and it has been 6 weeks and 4 days since my surgery.  When I try to look left (the direction my eye will not move to) I feel a little bit of twitching.  My hubby says when he watches it that it looks like my eye "wants" to move.  I guess he says it shakes a bit.  Nothing else though.  I still have my neuro-opthamologist appt on Monday so hopefully I will have some good news.  This is really getting old.
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Avatar_n_tn
Hi Debi, I am still seeing double in the bad eye, but it seems to be improving as i no longer need the stupid prism on my lenses!!! My eye is moving now i am sure it goes right over now, but the muscles feels tight and strain giving me pain so i dont try it to often. I am waiting for it to do it itself, fingers crossed!! My eye is still a bit off centre, more white of the eye in bad eye than good. I to have my appointent next week, what a joke hey!! 6 weeks for both of us. Im sure your eye will soon do the same, you been through much more with having the tumor and op, just needs more time to recover. Hope all goes well on Monday, please let me know how it went :-) x
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Avatar_m_tn
Huge night last night for me!!  My eye can move to the center!! It doesn't stay there unless I strain to keep it there but I can move it there!!  This is the improvement I have been waiting for.  Finally some hope that this is not going to be permanent.  I hope this is the start of a total recovery.
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Avatar_n_tn
There you go!!!!!!!!!!!!!!!!!!!!!! Well done :-)
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Avatar_m_tn
any updates? Mine is about the same... still better than a few weeks ago, but no noticable improvement since
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Avatar_n_tn
Hi you two!
Debi how did you get on?????
Mine still stable get good days and bad, but definate improvement on my 7th week now. Eye hospital on Thursday so i will see what they say.
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Avatar_m_tn
Eye dr. was happy that it started moving.  She wants to see more movement past the middle.  Right now it goes to the middle and every once in a while I can get it to go just a tad past the middle.  Not real obvious, but I have taken pictures and it does go just past the middle ocassionally.  She wants to see me in 2 months to see if it has improved.  Dr says it will be a spontaneous recovery when the eyes finally move in sync.  I can't wait for that to happen.  She says there is still no guarantee that it will get better but this is at least for now a good sign.  Let me know what your dr says....we can compare notes!!   Good luck!!
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Avatar_n_tn
Hi
Eye hospital appointment yesterday. They were very happy that the eye is now moving. The nerve is showing little damage now. So they are telling me that this should make a full recovery! How long?? Again it depends!! They have booked me in to see them again in two weeks and again in six weeks. They are looking for a much bigger improvement by then, fingers crossed. Whilst talking to them, they did say people they see with this do get better and only a few need treatment to move eye back. So I am happy now just to sit and wait knowing that it has got better and hopefuly keep going that way!!! If not then get me on that list to correct this bloody eye!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
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Avatar_m_tn
seems like my vision has been improving a bit, the deviation to the right side is not quite as bad as it was.  i am still seeing double mostly but it seems my eyes are able to focus a little better than before. (ie i can see a single image just left of strait ahead sometimes)  If i had to i could drive without a patch because i can focus on the real image but i prefer to drive with the patch.  i am hoping that in another 2-3 months i will be "normal" again
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Avatar_n_tn
Great news!!! Yes I am still driving with a patch, every day my eye seems better slow progress though :-)
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Avatar_m_tn
yea it has been 10 weeks and 1 day, 71 days of pirating.  i have grown my beard out the whole time, lol. i am looking wild.  i am just hoping that one day i can look back on all of this and be like "yea remember that time..., that was crazy..."
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Avatar_m_tn
Just an update.  My eye can now go almost to the far left.  It also follows when I look in the mirror and turn my head.  It still goes back to the right but all these little changes are great.  I cannot wait until it goes in sync with my other eye.  I sure hope it goes back to normal and doesn't just stop improving.  I got to stay positive.  Hope all is well with you two...let me know how you are.
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Avatar_n_tn
Hi Debi, great news :-) I am fine thank you, Small improvements, but I managed a food shop today with no patch, and I never even bumped into anyone!!!! My double vision is still present, but not as bad as it was. My eye is slowly moving, nearly back central now, but like you i think it will still be a while for better or normal vision. I have another appointment with the eye hospital at the end of May.
And to the Pirate!!! lol, Yep I am even looking back now and thinking, I do not know how I even got through the 10 weeks. I never want to go through this again.
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Avatar_n_tn
Hi Guys, just a quick up date. I was seen again today at the eye hospital, two weeks ago the scored my eye at 3 today it is a 1. So great improvement and I am noticing a much bigger improvement now. 10 weeks today so im hopefull in another 10 it will be normal again. Hope you are all well x
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Avatar_m_tn
That is great news!!  Where exactly is your pupil when at rest?  Does it still stay toward the inside?  Has that improved?  I can move my eye almost all the way to the left but of course it doesn't stay there.  At rest my "bad" eye does go back to the right but it's not as much to the right as when I first woke from surgery.  My eye doctor didn't give me a "number scale" so I have no idea what number I would be at.  I know my vision is perfect.  But honestly, that is the least of my concerns.  I don't go back to the eye dr. until July 18.  Let's hope it's normal by then :)
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Avatar_n_tn
Hi, No, my eye not looking in towards the right now, still off centre but nearly there!! my vision is very very slight double vision now.Though they said my eye is not fully in sinc with the other one yet! They said that even at 10weeks there is still a long way to go! Like both of you, I am just happy knowing that this is getting better, I still get good and bad days with the eye depending on what i have been doing that day. I have another appointment 5th july, they said they are looking to see me with a full improvement by then, fingers crossed. x
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Avatar_m_tn
hey you two well it has been 89 days.  mine seems to be doing better and better by the day, the double vision is nearly gone directly ahead of me and to the left however still double on the right side, but not nearly as bad as it has been.  i can blink my eyes when it is double and it will usually go back to single as if it is trying to get better but just hasnt had enough time.  last time i went to the eye doctor she told me i started at 30 (on their grading scale) the second appointment was at 25 and was currently at 15 i have seen noticable improvement since then and have another appointment on the 28th.  From my calcualtions based on how this thing has improved thusfar baring any setbacks i hope to be better within about 2 more months.
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