What is it?

The third cranial nerve, or the oculomotor nerve, is a nerve that controls most of the eye movements, the upper eyelid and is responsible for pupil constriction. In third nerve palsy, the patient will not be able to maintain a normal alignment of the eyes while staring straight, causing strabismus and double vision. Oculomotor nerve palsy may be congenital or acquired- caused by vascular disorders, tumors, inflammation, infection, trauma, multiple sclerosis, autoimmune disorders such as myasthenia gravis, post-operatively and as a result of cavernous sinus thrombosis.

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Signs & symptoms

A complete third nerve palsy causes the eye to look outward and downward. Other symptoms include ptosis, pupil dilation, double vision and torticollis.


Diagnosis is based upon findings from medical history and physical examination. Further evaluation may include brain MRI, CT or angiography.


Treatment depends on the underlying cause and if the palsy is complete or partial. The treatment of choice is usually surgical. Other treatments are given as supportive care and include closing the eyes, and botox injections.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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