4th Nerve Palsy, wearing a patch vs not

[kcosas]

HI, I was recently diagnosed with 4th Nerve Palsy by ER, Neurologist, and the Neuro - Ophthalmologist following a good concussion. My 2 images are quite far apart and lower damaged image is tilted about 25 degrees to the left.. The question I have is should I continue to wear a patch so I don't experience the double vision which is quite pronounced and disturbing? My Neuro - Ophthalmologist has told me to exercise the eye trying to line up the 2 images with the head tilt and concentrate to keep them together. He said initially do this for a few seconds at a time and about 5 hours apart. He said patience and time to let the nerve heal. Another person who suffered the same condition told me he took the patch right off and let the brain figure it out and retrain itself. Thoughts?

[kcosas]

Thanks, he says he learned to live with the double vision and was not conscious of it after 2 months. I'm not certain what that means, if he still has it and learned to live with it, not sure?

[Ricobord]

That is very interesting that only a child's brain learns to ignore a conflicting image.  I guess an adult with a permanent injury would have to patch the bad eye forever.

I would assume that patching the bad eye in your case is the right thing to do while it heals.  That's a bummer that you got conflicting advice on that.  I would personally go with the neuro opthamologist. They are more specialized on the eyes than a regular neuro.

I would be curious to ask the other guy who took the patch off after a few days what he sees when he covers the uninjured eye. Has his healed?

[kcosas]

Hi, I truly appreciate you taking the time to share your story.
I'm sorry to hear of your relative's troubles.
The Nero-Opthamologist told me that only a child's brains could learn to ignore the 2nd image and he definitely cautioned me not to patch the good eye, which I had been doing with the encouragement of my neurologist. He said that I would only strengthen the weakness of the bad eye doing that. I am wearing the patch over the bad eye and getting contradictory advice on how much I should take the patch off. One man I spoke with yesterday who is 9 months out from this condition told me he took the patch right off after just a few days and let his brain figure it out. It's difficult for me to imagine doing this, but would love to hear if this was successful for others. Thanks again for you time and comment.

[Ricobord]

I am no neurologist, but I have a cautionary tale about using.a patch in my family.  My close relative had a lazy eye as a kid. An optometrist gave him an eye patch at age 6 and told him to wear it over the good eye to force use of the weaker eye, thereby strengthening it. He wouldn't wear it, because the brain had already learned to ignore that eye and he just couldn't see well through it anymore. (Age six is clearly too late for this.).

Even though the vision in that eye was fine (it was a problem with the muscles controlling the eye), he lost nearly all vision in that eye.  He can only see dark and light and big shapes through that eye when he covers up the good eye. He has gone through life with no depth perception.

So, I would speculate that If the brain tires of trying to reconcile two differing images before the nerve heals, then the brain will just ignore the distorted image, in effect shutting down that eye.  If I were you, I would do what the doctor said. Think of it like physical therapy...it might be uncomfortable and difficult, but necessary to regain function.  No two people are the same, and you might not get the same result as the other person you describe.

Sorry to hear about your concussion!  I only had a mild one once and it was awful. I hope you heal quickly.