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How to manage double vision?

Dr Rishi Mohan
Consultant Ophthalmologist, Indraprastha Apollo Hospital,
New Delhi

Q: What is 6th sensory nerve palsy of the right eye? I have double vision and my left eye has moved towards the side of the nose There is a patch placed over this eye - vision of this eye is good but I cannot use it as I get dizzy on opening. What is the cause and treatment including the tests to be done? Is surgery required or will it correct itself?

A:There are 3 pairs of cranial nerves (3rd, 4th & 6th) that provide motor impulses to the extra ocular muscles of the eyes. They are responsible for the co-ordinated movements of the two eyes in all directions of gaze. The 6th cranial nerve supplies the lateral rectus muscle (situated on the outer/temporal aspect of the eyeball). Paralysis of the nerve, and hence the muscle, cause the eye to rotate inwards towards the nose. Since the two eyes are no longer co-ordinated and parallel in direction for all directions of gaze, diplopia or double vision results. Common causes of this condition are diabetes, trauma (head injury), raised intra cranial tension, etc.Most palsies tend to recover substantially with time. Rarely, surgicalintervention is required to re-align the eyes. A patch over the deviatingeye will take care of symptoms of diplopia during the recovery period.