What can I do to repair oculomotor nerve damage or, at least, correct some of the eyelid asymmetry? (photos)

When I was 3.5 years old, I suffered an injury which led to the damage of my third cranial nerve. I've had surgery to correct some of the unilateral damage of my left eye but my current state is unsatisfactory. I suffer from exophthalmos, poor vision, and limited motor abilities of my left eye. Additionally I have frequent headaches localized to the left eye region.

Doctor Answers 3

Eyelids #blepharoplasty #fillers #BOTOX

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Dear raghd21

Thank you for your question and photos!  Your eye/eyelid and brow shape are complicated by the neurologic changes- It appears that you have some lid ptosis on the Left upper eyelid with compensatory eyebrow elevation on the same side.  Any adjustment of the left upper lid may result in changes to the right upper eyelid as well as relaxation of the left eyebrow.  A careful assessment and consultation would be needed.

With Warm Regards

Trevor M Born MD

Third Cranial Nerve palsy

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There are several options for cosmetic improvement. I would recommend seeing an oculoplastic/ orbital surgeon for an examination and measurements - and a discussion of all the possibilities. Discussion of options should be detailed so that you know the risks, benefits, alternatives, and realistic expectations. Third nerve palsies are difficult to manage because of diplopia and lack of ocular motility, but improved symmetry in primary gaze is a realistic goal. The headaches should also be assessed and treated. Although an oculoplastic surgeon might shed some light on the etiology, you should probably start with your primary care doctor for workup of the headaches. Best wishes.

See oculoplastic specialist

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There are several options that can help you but nothing will make it good again. It is a complicated issue that needs proper evaluation and discussion with an oculoplastic specialist.

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