Fourth Nerve (Superior Oblique) Palsy

[Fliegenmong]

I seem to have developed this condition over time....

Fourth Nerve (Superior Oblique) Palsy — AAPOS (http://www.aapos.org/terms/conditions/52)

Now maybe I have had it for a long time.....now that I have been diagnosed I think perhaps I have...... will be having surgery for it later next Month, and was wondering what implications there are to a medical?

Both Eyes are 110% vision perfect, even at 40+ I can rattle off the lowest / smallest line on an eye chart no worries! But the head tilt, right eye delay / laziness......?? Corrective muscle surgery is scheduled for 21 Feb., sure hope the guy knows how and where to cut and reattached various muscles to make me 'aligned' again! :sad:

[Fliegenmong]

15 days to go........ :ouch: :eek:

[Capt Chambo]

Was diagnosed with the same condition 11 years ago. Post op. I am within 1 diopter of where I need to be and that's how your surgeon should leave you. No more head tilt, with restricted downward movement of the eye but within limits. Originally I lost my medical but got my UK CAA medical back afterwards, and now have an Australian Class I. I never had diplopia (double vision) and it will take you a while to adjust after surgery.

Feel free to drop me a pm if you want to talk about it.

[Fliegenmong]

Thanks Capt. Chambo for the kind words....very much so! I'm being admitted tomorrow morning, around about 13 hours from now...Very anxious indeed!, (naturally) eyesight has always 20/20 +, but so many little things make me realise I've had this for ages! .... Like closing the right eye in a rapid move of head form right to left, if I do it with BOTH eyes open, the right is left way behind!, one millisecond blink fixes it.....and picking up a glass to drink the right closes, or sees nothing until the glass moves away again (Unless I close my left eye then the right sees everything perfectly!

I can understand how a surgeon removes appendix, or sets a broken arm, or an eye guy removes a cataract....how an Ophthalmologist measures eye deflections to determine where to cut and re-attach eye muscles on the sclera, is , well, I hope he gets it right, I'm sure he's the best I can get..a lecturing professor at the University of Queensland....thanks again for the advice on a while adjusting...I'll let you know how it all goes.... :uhoh::ok:

[Fliegenmong]

Was what was in fact required.....

Here.....

Inferior Oblique myectomy - YouTube

Recovering well I think.....Taking some getting used to the brain processing images, all a bit scary

[Capt Chambo]

Hope the recovery is going well. Looks like you had a slightly different operation to the one that I required, I had a modified Harado-Ito with a slight adjustment on the non-affected eye.

Post Op. I took a while to regain depth perception, so no driving, and I walked like a man who had taken too much ale! That disappeared after about a week, i continued to struggle with depth perception for a while longer particularly when looking up quickly! Having carried my head at an angle for the previous 6-7 years it took a while for my neck muscles to adjust to now carrying my head level, and 11 years on I still have a very slight tendency to tilt my head.

3 months post op. I regained my UK CAA class I with no restrictions except that I now needed glasses for reading, and I was required to see the CAA's ophthalmologist after a further year as a follow up. I have subsequently passed Asian and Australian Class I medicals. I still do not have full down gaze mobility in the eye, but that was to be expected and I retain 1 diopter up, (having been 23) in the affected eye.

Good luck.

[Fliegenmong]

Thanks Capt Chambo......I really have appreciated your contributions!!! My depth perception seems OK, I have been doing some driving.....not sure if the head tilt is 100% just yet, though it felt just right on Sunday morning, if I only look out of the operated eye I still pick up a 'Vertigo' like feeling, absent as soom as both eyes operate, and never present in the 'Good Eye'.....but still I have a month to settle down....and we'll see how it pans put from there, after I've seen the Ophtho on 21 March.....