Strabismus surgery in congenital third nerve palsy

Congenital third nerve palsy is a rare condition that usually presents with a large-angle incomitant strabismus and is often associated with ptosis and amblyopia.

We present the results of strabismus surgery in seven consecutive patients. RESULTS; All the palsies developed before the age of 6 months and the age at surgery ranged from 3 to 24 years. The operations performed included horizontal recti resection/recession (7), supra-placement of the insertions (6), superior oblique weakening (4) and traction sutures (4). The preoperative and postoperative horizontal deviations consisted of seven exotropias and one esotropia due to a combined sixth and partial third nerve palsy. The preoperative vertical deviation consisted of 7 hypotropias and one hypertropia; postoperatively, 5 remained hypotropic and 2 were hypertropic. All patients underwent ptosis surgery.

Patients with congenital third nerve palsy often achieve reasonable cosmesis with strabismus and ptosis surgery.