Third Nerve Palsy (Oculomotor Nerve Palsy) Treatment & Management

Updated: Jan 06, 2022
  • Author: Fiona Costello, MD, FRCP; Chief Editor: Andrew G Lee, MD  more...
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Treatment

Approach Considerations

Specific medical and surgical treatments for third cranial nerve palsies will depend on whether the underlying etiology has a favorable natural history (microvascular ischemic third nerve palsy or RPON) or is amenable to treatment. Non-steroidal anti-inflammatory agents often are used to manage pain in these clinical situations. From a practical standpoint, diplopia can be treated with patching (acutely) or Fresnel prisms after formal orthoptic consultation. For more refractory cases, ground in prism can be modified with spectacles or patients may be candidates for strabismus surgery is to provide alignment in primary and reading position.