-
What is fourth nerve
palsy?
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How is fourth nerve palsy
acquired?
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How does this condition present?
-
What are
the treatment options for fourth nerve palsy?
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How do I get
more information?
What is fourth nerve palsy?
Fourth
nerve palsy is a paralysis of cranial nerve four that innervates the superior
oblique muscle of the eye. This muscle is primarily responsible for intorsion,
and secondarily for depression of the eye.
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How is fourth nerve palsy
acquired?
Fourth
nerve palsy may either be congenital or acquired. Although birth trauma is an
unlikely cause, it is a possible etiology for the congenital variety. The
acquired type is more common in older children or adults who sustained a closed
head trauma, even in the mildest form such as brain concussion. A history of
loss of consciousness is very common.
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How does this condition present?
Due to
the chronicity of the problem, a child with the congenital type develops an
abnormal head posture to compensate for the effect of the paralysis on ocular
muscle movement. The child usually has a head tilt and face turn opposite the
affected side, and a chin-down position. Although bilateral involvement is
commonly found in the acquired variety, it could be asymmetric, presenting with
the classic abnormal head posture just mentioned. However, in the rarer
occasion of symmetric involvement, the patient would only have a chin-down
position because the effect of the bilateral involvement on head posture cancels
each other. Double vision or diplopia is more commonly found in the acquired
type, particularly in the reading position. On the other hand, children with
the congenital variety do not complain of diplopia due to suppression of the
image on the affected eye. Amblyopia or lazy eye, as well as neck muscle
contracture opposite the affected side, are not unusual in these cases.
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What are the
treatment options for fourth nerve palsy?
The most
common complaint among patients with the acquired and congenital type is double
vision and abnormal head posture, respectively. Adults with the condition
usually cannot tolerate the double vision at near. Surgery on the overacting
and/or contractured eye muscle(s) in one or both eyes, depending on the results
of eye movement examination and head tilt test. The more chronic the condition,
the more muscles are affected. The corrective surgery can usually be done in
one stage. However, a second surgery is usually necessary in the case of
asymmetric involvement or masked bilateral involvement. The apparently
unaffected or less affected eye becomes more obvious after doing corrective
surgery on the more affected eye.
There are several ways of reaching the ophthalmologists of EYE REPUBLIC Ophthalmology Clinic:
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ONLINE ACCESS
WEBSITES.
http://www.EyeRepublic.com.ph - EYE REPUBLIC
Ophthalmology Clinic
http://www.OCP.com.ph - Ophthalmic
Consultants Philippines Co. -
http://www.LASIK.com.ph - Refractive
Surgery Resource
http://www.Cataract.com.ph - Cataract Surgery Resource
http://www.Eye.com.ph - Eye
Information Online
http://www.EyeDoc4Kids.com.ph - Eye Information for Kids
http://www.Retina.com.ph - Retina
Surgery Resource
http://www.Glaucoma.com.ph - Glaucoma
Online
http://www.Uveitis.com.ph - Uveitis Online
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EYE REPUBLIC
Ophthalmology Atlas
CLINIC INFORMATION
Mobile E-Yellow Pages. Via
SMS, text LUK4 EYEREPUBLIC
(send to 2851 for Globe and Sun Cellular, and 2951 for Smart). |
EYE REPUBLIC Ophthalmology Clinic
Manila
3/F Don Santiago Building Units 309-310
1344 Taft Avenue, Ermita
Manila, 1000 Philippines
Direct and Fax: (632) 536-2398
Trunk Line: (632) 523-8271 to 79 local 30
Mobile: (63917) 899-2020
Map and directions
|
EYE REPUBLIC
Ophthalmology Clinic
Asian Hospital
and Medical Center
5/F Medical Office
Building (MOB) Suite 509
2205 Civic Drive,
Filinvest, Alabang
Muntinlupa City,
1781 Philippines
Direct:
(632) 771-9253
Direct and Fax:
(632) 771-9254
Mobile: (63917) 795-2020
Map and Directions
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EYE REPUBLIC Ophthalmology Clinic
Medical City
6/F Medical Arts Tower Inc (MATI) Suite 602
MERALCO Compound, Ortigas Avenue
Pasig City, 1604, Philippines
Direct and Fax: (632) 632-7846
Mobile: (63917) 537-2020
Map and directions
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EYE REPUBLIC
Ophthalmology Clinic
St. Luke's
Medical Center
6/F
Cathedral Heights Building Complex (CHBC)
North Tower Suite 614
279 E. Rodriguez
Sr. Boulevard
Quezon City, 1102
Philippines
Direct and Fax:
(632) 407-3883
Mobile: (63917) 855-2020
Map and directions
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CLINIC HOURS
First-Come, First-Served
Monday to Saturday 9:00 AM to 6:00 PM
All clinics are closed on Sundays and Holidays
|
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FOURTH NERVE PALSY information
compiled by Dr.
Barbara L. Roque and initially uploaded on July 24, 2005.
Last updated on
September 20, 2007. |
