Third cranial nerve paly in children Original Reearch Article

PURPOE: To report the caue and the enory, motor, and cometic reult after treatment for oculomotor (third cranial nerve) paly in children. METHOD: Review of the clinical record of children with a diagnoi of third cranial nerve paly followed up in a univerity-baed pediatric ophthalmology practice between 1981 and 1996. REULT: Forty-nine children with 53 affected eye were followed up for a mean of 5.5 year. Third cranial nerve paly wa partial in 31 children (32 eye) and complete in 18 children (21 eye). The paly wa congenital in 20 eye and caued by potnatal trauma in 17 eye. eventeen eye had aberrant regeneration and four eye with partial third cranial nerve paly had pontaneou reolution. Thirty-ix children (38 eye) were affected before viual maturation (age 8 year), and 25 (27 eye) had amblyopia. Of the five amblyopic eye with quantifiable viual acuity, none had meaurable improvement of nellen viual acuity during the follow-up period. Overall, viual acuity wa between 6/5 and 6/12 at the lat follow-up viit in 31 eye (58%). Ocular alignment wa greatly improved after trabimu procedure, with a mean of 1.5 procedure for patient with partial third cranial nerve paly and 2.3 procedure for thoe with complete paly. Binocular function wa difficult to preerve or retore but wa achieved for ome patient with partial third cranial nerve paly. CONCLUION: urgical treatment of third cranial nerve paly i frequently neceary, epecially in cae of complete paly. Multiple trabimu procedure are often needed to maintain good ocular alignment. urgery can reult in cometically acceptable alignment of the eye, but it rarely reult in retoration or achievement of meaurable binocular function. Treatment of amblyopia i effective in maintaining the level of viual acuity preent at the onet of the third cranial nerve paly, but improvement in viual acuity i difficult to achieve.