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Sixth Nerve Palsy diagnosed with no cause
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Sixth Nerve Palsy diagnosed with no cause

Hi,

My husband 36yrs woke up with a distorted,super imposed vision. We took him to ER, the Dr's performed blood test for diabetes, MRI and MRA. All tests came back normal. Blood pressure was also in normal range. We were referred to an Opthamologist who did field test on the eyes and said everthing is normal. Only reason they could relate to is his migraines (which he has now and then).

His left eye when he is moving to the left is stuck in the middle and doesn't move. The opthamologist has told us it is Sixth nerve palsy and would take 3 months to recover. Does patching of the left eye help? How can we do to make the recovery faster? Are there any vision therapy or eye exercises that can be done? When would the vision start to get better.

What are our options? Any suggestions would be appreciated. Thanks

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Avatar_f_tn
Hello,
   Welcome, although circumstances for visit I know can be concerning to say the least....Now, I am SSssOOooo glad that you took him right away...So nothing showed on the mri...thats great...no rupture in the brain...blood pressure ck and diabetes  (btw, was it just a blood test or did they do a urine also), Does he have any dizziness when moving body?,head?, eyes?....How many of things does he see at one time....I have had up to 6 of the same things stacked right beside each other...(of course there was only one)....I was told that there were no exercises that could change the position of the eyes once damage was done..,.especially in my case (sub-arakanoid hemmorage...PCA, third nerve at the brain stem),   I NOW BEG TO DIFFER!!!! I sat in my car, sometimes up to 6 or 7 times a day for approx 15 - 20 min at a time for almost 2 months and this is what I did. I would put the patch on the right eye(better eye)...then sit in passenger seat with mirror down...I would watch my eye watching me, and then move it back and forth - left to right - then far left to far right...up and down...look out over to horizon..look up close....The eye is now almost exactly where it was before and I only see 2 or sometimes 3 depending on other health issues and exposures....My eye dr put something on my glasses, although now I forget what it was called....,okay, I'll explain it...You know a pictures that looks like one thing then when you move an inch...the picture changes...that is caused by the plexy glass type of material that has a bunch of BI-focals looking lines on and unevenness to it....it is not smooth and the name still escapes me...(brain freeze), anyway he put one of those on the left lens and that regulated it to from what I did see,  to seeing less of them....not a kalidiscope, not bi focal, I keep wanting to say paralulligram and I know that is not right...I'm going to send this and when I find that word I want I will post seperate....
...Things like this can come from the oddest things, viruses, cold type symptoms...has he been out of the country or had any other health issues...I hope you find the answers you seek and the eyesight he needs and both you all want..Please keep us updated....Have a better Blessed Day!!!!     GOD BLESS!!!!    loimmarmar
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144586_tn?1284669764
Yes, a patch over thye affected eye is the usual treatment, however it should not be worn more than 12 hours a day (ballpark). Ocasionally, if vision is entirely cut off, the optic nerve deteriorates.

Basically, there is no other treatment other than watchful waiting.

As you have been informed the condition usually resolves with two to three months, but may return.

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Avatar_dr_f_tn
Hi there. To maintain binocular vision, Fresnel prisms are used. These prisms are attached to the patient’s glasses or to plano glasses if there is no refractive error. Other management options include use of botulinum toxin, injected into same side medial rectus, which helps prevent the contracture of medial rectus. By removing the pull of the medial rectus, it may serve to reveal whether the palsy is partial or complete by allowing any residual movement capability of lateral rectus to operate. The recovery may take 9 to 12 months of wait and watch period after which management will be either conservative or surgical. Consult your ophthalmologist for further advice. Hope this helps. Take care.




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Avatar_f_tn
Hello again,
    YES YES YES.......PRISM......I knew it was a simple word....and Thank You Dr for your ability to know just what I was describing....Now for the advice given by you as well as caregiver222, There is great knowledge here and as said the best thing is keep a watch....I did want to clairify one point.....THE eye patch....I went back and re-read what I wrote and I did say about putting it on the GOOD eye, so that you could watch yourself watching your troubled eye in the mirror...Sometimes, if one eye is expected to see because other eye is covered then the brain will attempt to compensate, and that, in and of itself will start the exercise process....You do not do it for long at any one time or to the point of eye or head pain...and yes I did use the patch on the other eye at times....but only to keep from being dizzy as that would come and go with movement...but not always...and I like that I learned about the time frame of wearing the patch and yes it makes perfect sense...Keep us in the know..Have a wonderful Blessed Day!!!!     GOD BLESS!!!!!      loimmarmar
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Avatar_f_tn
Thanks everyone for taking time to post your comments.Appreciate it so much. He has put a patch on his left eye and switching twice a day to right eye. He has been taking rest for the past week since it occured and we can  see little bit of difference.

when he is trying to see his left when this happened his left eyeball was stuck in the middle and wouldn't move to the left but today we noticed that he is looking to the left his left eye ball is slightly tilted to the left. Hopefully he will recover soon. We have asked Opthamologist for prisms and she mentioned that it wouldn't help him even with prisms.

Left a message for Opthamologist regarding  botulinum toxin. Will see what she has to say.Will keep posted.
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Avatar_m_tn
Hi Kavya,
My husband is having same problem as you mentioned in your post,could you pls tell me,has he recovered from that and what intervention he had?If he fully recovered,how long it had taken?
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Avatar_m_tn
hi Kavya... so its been years... can u tell me if this was resolved and how long it took for him to recover after onset ? I am facing the same problem with my 9 month old baby which we could not digest to see her like that.. plz reply..
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10389859_tn?1409925468
I'm not sure if you will get a reply since this thread is over a year old.  If you are concerned with your baby, I suggest you have him evaluated by your baby's doctor.
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