Hi - 4 weeks ago out of the blue I developed eye problems and also fatigue. I saw a neuro opthamologist and he found the 4th nerve palsy. I has 2 cat scans, an MRI & MRA and a spinal and of course all kinds of blood work, nothing is showing up. Basically the doctors are stumped. Anyone have the same symptoms? Or any ideas? Thanks
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First Helper Mikeyren
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replied August 9th, 2008
4th nerve palsy
I recently noticed a 4th nerve palsy myself in my left eye on right gaze. I happen to be a physician and saw an opthalmologist yesterday. He referred me to a neuro-opthalmologist. My eyes are totally staright in frontal gaze, only double vision when I look up and to the right????? I am sure I will have the full work-up too. Sometimes these can be unmasked congenital things. Did you ever get any answers? How old are you?
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replied November 17th, 2011
Trochlear nerve palsy solution
I have exactly the same problem. Suffered vertical double vision due to fourth nerve palsy for three and a half years, wearing strong prism glasses to help but still not being able to play sport etc. Finally I found a surgeon who operated on the opposite eye and by moving the muscle at the bottom of the eye down 5mm, my vision is now perfect. I have no idea what caused the palsy or whether it will ever start working again, but in the meantime I can now live normally again!!
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replied December 22nd, 2011
4th nerve palsy surgery
I just had surgery 1 month ago to correct a 4th nerve palsy and it was very successful. I had double vision my whole life and now I don't. The procedure takes 40 seconds once you get numb. It was Dr. Kenneth Wright in los angeles.
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replied November 2nd, 2018
Mikeyren, can I contact you to discuss your 4th nerve condition?
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replied March 16th, 2009
4th nerve palsy
I recently was diagnosed with 4th nerve palsy as well showing the same symptoms as you, all the tests & blood work & doctors as well, It is very hard to read watch tv, ride my bike & especially drive, actually as of yesterday I have stopped driving it's too stressful.
The doctors said to wait 6 months & if it is not better surgery is iminant, Do you have any alternative ideas to share the thought of surgery doesn't thrill me .
I am 57 years old & in perfect health.
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replied April 11th, 2009
so what happened?
Did any of you get any kind of resolution? My husband has just had a brain attack, 4th nerve, lots of fatigue, hard to see.
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replied April 17th, 2009
I have recently found out i have fourth nerve palsy last year and it was definatly a scare. I noticed I had it when I got hit in the head with a baseball because I saw two baseballs. It occurs when I look to my right, and it turns out I was born with this. It has gotten worse over the years
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replied April 23rd, 2009
4th nerve palsy diagnosis
I have just been diagonsed with 4th nerve palsy. This after almost 2 months of troubling vision problems. I spent 5 days in the hospital, had an MRI, all the bloodwork, a CT scan, and a consult from an opthamologist (who obviously overlooked the problem). All reports came back good, no diagnosis was made, and I was sent on my way. I was still having extreme difficulty seeing and having headaches, and I went to an optometrist, who tried, unsuccessfully to help me see better. Now three weeks later, I have seen a different Opthamologist who has given me this diagnosis of "4th Nerve Palsy". He has arranged an appointment with a Neuro-Opthamologist at the U of M hospital. Any feed back regarding what to expect would be helpful. This has been a scary experience.
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replied October 2nd, 2013
Can you let me know what your outcome was with the neuro opthalmologist? I am suffering from 4th nerve palsy for a month now and after mri of brain and orbits and mra of brain my neuro opthalmologist does not know what is causing it but it is completely stopping my life. I am only 40 yrs old with young children and cannot think of just adapting to this and waiting for it to possibly go away. I am researching alot about this type of surgery they do to correct it. I have alot of headaches and eye pain that I am on painkillers now for.
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replied October 21st, 2013
Hi! I am going through the same thing. Have had a battery of tests, have some results back (all negative) and awaiting a few more results. I am meeting with a surgeon next week to find out my options. Have you been referred to a surgeon as well? This is very frustrating and inconvient to a busy life. Let me know if you'd like to chat more. We can provide support to one another.
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replied May 17th, 2009
fourth nerve palsy
I have hydrocephalus, paranaud's syndrome and a fourth left nerve palsy. It is very frustrating because although I can no longer wear contacts, (I wear glasses with prism), however my vision problems are intermittent. I went to Wills Eye Hospital in Philly and I was told I was too complicated. Any suggestions of where to go next?
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replied December 22nd, 2011
A dr in los angeles has developed a new procedure call a mini tanatomy. I had it done and it was an excellent result. No more double and no more ey strain. My life is starting over since I had this done. I feel like a new person. Contact me and I'll tell you about the success of this procedure
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replied February 1st, 2012
Can you please tell me who the doctor is. I believe I have this 4th nerve palsy and have an appointment with pediatric opthomologist in the morning. I'm 51 years old and live in Arizona. Appreciate any info and details on your success . I'm beside myself with worry right now.
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replied March 17th, 2012
Fourth nerve palsy
Hi Mikeyren, I was so encouraged by reading your experience. I have the same problem and symptoms as you had. Could you send me a detailed account of your treatment? I thank you in advance.
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replied March 17th, 2012
Fourth nerve palsy
Hi Mikeyren, I was so encouraged by reading your experience. I have the same problem and symptoms as you had. Could you send me a detailed account of your treatment to my email id? I thank you in advance.
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replied March 28th, 2012
Mikeyren,
I had eye muscle correction surgery at Will's Eye Hospital(Philadelphia, PA), 2 years ago and it changed my life after 12 years of dealing with this debilitating condition. I think this may be slightly different than your procedure, but it is an east coast option for those who are interested. The procedure was about an hour and quick recovery time(Friday surgery back to work on Tuesday). If anybody needs more information message me and I can provide further details.
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replied June 18th, 2012
Have you found out anything as of yet about this
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replied October 2nd, 2013
Can you provide me with the name of the surgeon that you used for the surgery? My 4th nerve palsy came on suddenly 1 month ago and after having several tests such as MRI and MRA there is nothing showing why this happened but it is ruling my life right now and being that I have young children and active life I can't live like this so wondering if surgery is the right thing for me.
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replied June 13th, 2012
hello my name is Consuelo, I would love to know more about the procedure.
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replied June 13th, 2012
Can you tell me more about this please
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replied May 19th, 2009
fourth nerve palsy
I just got diagnosed with 4th nerve palsy on my left eye. I see double when looking straight or down since 2 weeks ago. Did blood work, MRI...everything came out normal. For now I am wearing prism lenses on my left eye that the neurologist prescribed and if the problem doesn't fix itself in 4-6 months then I will probably need surgery. For those of you who have 4th nerve palsy, ask the doctor about prism lenses as a temporary fix....after that its pretty much a waiting game. Make sure you get your MRI (of the brain), and necessary blood work to check for syphillis, lime disease, and tuberculosis...all these can cause damage to the nerves. If the problem doesnt fix itself in 6 months then surgery should be discussed. Make sure you get always get a second opinion before doing any sort of surgery. Hang in there...as will I!
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replied June 18th, 2012
Can you PLEASE contact me about this, I too was just last week diagnosed with this!!!
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replied May 19th, 2009
wearing prisms
I have prism lenses. For the past two days I have been going wearing no glasses because I see better than when I have them on. Well the double vision is gone for now anyway. I just made an appointment with a neuro opthamologist and I have a MRI tomorrow. I will probably get the same results as always, that being they are clueless.
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replied July 10th, 2009
lesions on brain
For about a week now I have been having double vision and headaches. The opthomologist thought a possible 4th nerve palsy and sent me the next day to have an MRI on my brain. I was fortunate enough to be able to get the MRI results immediately and sent to a neurologist. There are some lesions on my brain but they are not really sure why and they want me to go to a MS specialist who of course is booked and cant get me in until late Sept.! All of my blood work came back fine, checking for things like Lyme disease and vasculitis. I cannot work, I cannot drive and I am terrified. Both doctors assure me they believe this will resolve itself on its own but I was hoping that meant weeks not months! Also, the opthomologist did play around with the prism over my eye but said it would not be worth it because my vision was different with every direction my eyes look or position of my head. I guess my question is has anyone else had spots or lesions seen on the brain MRI?
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replied August 28th, 2009
I have been diagnosed with fourth nerve palsy and pseudotumor cerebri since I was 7 years old. I am now 12 almost 13 years old. My opthamologist said it was very rare to find this diagnosis in children. I have perfect vision except the fact that when I tilt my head to the right and look to the bottom left I see double-vision. I also get headaches pretty much every week. The double-vision hasn't been a problem for me at my young age but my eye doctor brought up a good point, that when I get older and am able to drive my double-vision could get in the way. I have been taking diamox or however you spell it since I was 7. My opthamologist has had numorous attemps to take me off the medicine, but somehow I always ended up back on it. I've had several cat scans, MRI's, and two lumbar punctars. The double-vision hasn't gotten any better throughout the years. I'm thinking of getting surgery to correct it but I don't know when the best time would be to do it. Any ideas or suggestions? Please write me with your comments
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replied September 6th, 2009
My experience with 4th nerve palsy
I woke up one morning 6 years ago with double vision after having some deep dental work. I immediately thought it had been the injection but my dentist insisted it was not. I went thru the cat scan, neuro opthomologist visits, waiting for a year for my brain to learn to compensate, using prism glasses, ad nauseum. I finally found a pediatric opthomologist who told me that anyone with 4 prisms had suffered enough and went ahead and did the surgery. He unfortunately overcorrected me so my double vision went from the left side to the right side, even to the point of being worse. I went ahead and re did the surgery and now do quite well without prism glasses even though I still have about 2+3 prisms of double vision. The final diagnosis was that since I had a heart murmer, I should have been premedicated at the dentists office and in fact that is where the small stroke had been precipitated. I believe the dentist knew that but got scared. Consequently, make sure you are aware of your medical history even at the dentist's office since things like that can happen. The Dr who did my surgery was Dr Epley in Kirkland Wa. Great Guy.
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replied October 12th, 2011
dental proceedureseva
i had dental work done within 3 hours i had double vision the eye specialist cannot tell me if my eyesight will return when i told my dentist he said it was impossible he caused the damage
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replied January 4th, 2010
I suddenly noticed that I had double vison 7 days ago. No
injury. Called my Primary MD and he told me to see a Opthomogist immediatly...that wound up being 24 hrs later. He did tests and said he thought I have 4th nerve palsy. He also told me to see my Primary MD and get an MRI. Ok..another day goes by, and I got my MRI the day
before New Years Day. So, I will not hear anything until
this coming Monday...(if I call). Meanwhile..the double vision is really bad. I can tilt my head downward and look up and it looks ok. Enough of that and my neck hurts! I cannot find the prism glasses. The patch is a real pain...and not a good look while driving..I haven't started driving yet...I just want to hear that it hasn't
lasted a long time for someone! Any eye excercises I can do? Has anyone tried steriods?? I had never heard of this
thing until I got it...and I am about to turn 64! Help!
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replied June 8th, 2011
I am 63 yrs old also and have 4th nerve palsy as a result of a poisonous insect bite....It is very frustrating. The eye dr. said it should clear up with time, it's been 6 weeks. He said eye exercises won't help. My chiropractor did some head massage and pressure stuff, also told me to check with an accupuncture specialist. The idea of someone sticking needles in my eye scares me. Reading all these blogs scares me. I wake up every morning, hoping I can see straight! It helps to know there are others out there with the same problem..... sorry if this hasn't helped you, I guess I just needed to vent!
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replied September 23rd, 2011
acupuncture
I am currently having acupuncture to help with fourth nerve palsy. Just wanted to reassure you that the needles do not hurt and they do not go into your eyes. I am taking herbs and seeing a chiropractor as well. Have been to a host of the best doctors in this area ( Philly/So. Jersey) and have yet another prescription to fill for prisms in my glasses. Been down this road before. I'll have them make the glasses but I mourn the loss of my contacts. I had cataract surgery at age 51, enjoyed a year of fabulous vision ( slight correction in glasses but was legally blind in one eye and only correctable to 20/50 with glasses in the other prior to surgeries) and then started to see a flashing light, which I'm told was a vitreous detatchment. Eventually, my brain stopped seeing the flashing light ( well, sometimes I see it but not 24/7 as before) then, for no apparent reason, the vertical double vision started. That was four years ago! Neuro-opth, said, 'thyroid eye disease" and eventually, I did have to go synthroid but last month was finally diagnosed with fourth nerve palsy. It's inconsistent, though, which means that the surgery results will be inconsistent. UGH!! I just want to see and to be independent! Incidentally, since doing the acupuncture, my acuity has improved one line for each eye but unfortunately, I still have the double vision.
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Thanks for your patience!

replied January 9th, 2010
Judibo, I have been going through the same thing since July 2009. You have to get a prescription for prism glasses. They had me on high dose steriods for 6 weeks and it did not help at all except about drive me (and my family) insane with the side effects. I am awaiting an appointment (Feb 5th!) with a strabismus specialist in my town. I go to a chiropractor for the severe neck pain from head tilting. The patch, and now the prism glasses help not have to head tilt as much and neck is improving. I am also seeing an accupuncturist. The last 3 days I have been able to go without the prisms for half the day. I am hoping this is an indication of healing! This same type improvement happened to me in November, and then after a stressful house move, the diplopia came back strong again! Lessening stress in your life may help the healing as well. i am hopeful this will resolve itself as all the doctors say it will. Never dreamed it would be going on this long! (end of January will be 6 months!) I am 48 yr female.
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replied January 10th, 2010
Thanks for the info. I have an appointment with the neurologist on the 18th of Jan. I know from a previous MRI that I do have plaque spots on my brain. That was three years ago and the neuro said it was from previous head trauma and he thought it was just scar tissue...not to worry. When this started I was under a LOT of stress. I wonder how much this has to do with it. I do have a RX for the glasses and I will get them next week. I figured if I put the money out for glasses ....my eyes will probably fix themselves immediatly! I will post after I see the Neuro. Thanks for the info!
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replied February 15th, 2010
4th nerve palsy
My 4th nerve palsy resulted from a cavernous malformation (brain lesion) on my brain stem that bled out damaging the 4th nerve. Originally mis-diagnosed at UT Southwestern neuro-opthamology - a very frustrating experience. Finally visited Dr. Siatkowski, nero-opthamology, at the Dean McGee Eye Institute in Oklahoma City. Thank God for him. He totally knows what he is doing. Diagnosed the 4th nerve palsy and has monitored any changes during the last few months. He was hoping my eyes would self-correct, but that isn't happening. He will probably suggest surgery after my next visit. Also, in my case, prisms did not work at all - they made things more difficult to see. A couple suggestions: Don't always trust that the doctor knows what he is doing because there is an MD by his/her name. If they don't look confident, they aren't. Find a second opinion. Also, it may be a good idea to have your MRI viewed by more than one radiologist. They could be missing a lesion like I had in my brain.
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replied August 22nd, 2010
Dr. Leonard Nelson (Will's eye Hospital Philadelphia, PA) changed my life. Struggled with 4th nerve palsy for 12 years and 2 hours of Dr. Nelson's time along with eye muscle surgery the double vision is 99% gone and no headaches! I had the surgery a week ago and the next day I was already healing and now a week later I FEEL ALMOST COMPLETELY HEALED! I urge anyone with this issue seek out and make an appointment with Dr. Nelson as I am so glad I did.
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replied January 5th, 2012
4th Nerve Palsy
I am a local dentist who has been diagnosed with 4th nerve palsy and was told that there was nothing that can be done. I am suffering terribly. Please contact me when you have time to hear about this potential miracle. Thank you so much for caring enough to share
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replied October 27th, 2010
I was diagnosed with fourth nerve palsy just this last Monday and I am now getting ready to go in to have my MRI and blood work done on Friday morning. I have never been so scared and stressed in my life and reading some of the posts on here have helped me realize that it's not rare Smile I'm just hoping that we figure out what's causing this and hope I can get it taken care of cause the headaches and neck pains are horrible! Thank you all for sharing!..
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User Profile
replied December 4th, 2010
4th Nerve Palsy experiences
I was diagnosed with 4th nerve palsy two weeks ago. The previous week I'd started having just a bit of double vision that got steadily worse as the week went on. I also am wondering if I might have had a microstroke or something, as I had had a couple periods of mild disorientation the week before that.

I am 49 years old and have type 2 diabetes that I was not managing at all well until fairly recently. The eye doctors basically told me that 4th nerve palsy is a not-uncommon complication with diabetes, and told me it would most likely go away within 90 days. I have noticed a bit of improvement this week, especially in the couple of hours after I wake up, but have to wear an eye patch to avoid the double vision, and am not driving at all because of it.

Does anybody have any experience or opinions with driving with an eye patch? That is really the most disruptive thing about this whole experience. For the last two weeks, my partner has been driving me to work and back (and everywhere else), and it's a pretty long commute. I'd really like to start driving again if its reasonably safe.
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replied March 28th, 2011
Billie

Fell and hit my left temple fairly hard 2 years ago. Had to get new glasses and have had trouble focusing while reading ever since. Have been back to get glasses adjusted 5 or 6 times without any improvement. About 4 months ago, my eyelids started itching causing me to rub them a lot. About the sametime started having high blood pressure for the first time in my life. Suddenly developed double vision Feb. 14, 2011. Went to ophthalmologist next day who ordered blood work and MRI. Both came back normal. He diagnosed problem as 4th nerve palsy and said it was a pinstroke to the muscle of my eye. Said it should resolve itself within a few months. I'm wondering if my fall 2 years ago was the beginning of my problem

I find I can avoid double vision by tilting or turning my head to the right while looking toward the left or by holding my head down while looking up. I do this when I have to drive or while walking around. The eyepatch cuts off too much of my vision. I use the eyepatch mostly when working on the computer.
Somedays I think it is getting better but other days it's pretty bad. I have an appointment with a neurologist-ophthalmologist for April 28 for a second-opinion.

Has anyone had any experience with eyerobics and vision therapy that's being promoted on the internet for all vision problems?
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