DR. ATULYAKRUTI GUPTA

Dr. SONALI RAO, DR. ATULYAKRUTI GUPTA

Abstract

It is commonly acknowledged that surgery for correction of paralytic strabismus associated with 3rd nerve palsy can be the most challenging for an ophthalmologist. Several staged procedures are required to accomplish an optimal correction, to assess results prior to considering further options and to avoid anterior segment ischemia. Understanding these difficulties, we present Modified Nishida: An Innovative Approach to Tackle 3rd Nerve Palsy. In our case, the exotropia and hypotropia in an 8yr old child with RE congenital 3rd nerve palsy was corrected by a single-staged surgery – MR plication + LR recession + Modified Nishida; followed by correction of severe ptosis with frontalis sling surgery, 2 months after squint surgery. Adequate alignment of the two eyes in primary gaze with good stereopsis was thus achieved with this innovative, simple and effective technique with no anterior segment ischemia, making this technique worth bearing in mind while tackling 3rd nerve palsy.