What are the contraindications for surgery to treat trochlear nerve palsy (fourth nerve palsy)?

Updated: Oct 08, 2019
  • Author: Zafar A Sheik, MD, MD; Chief Editor: Andrew G Lee, MD  more...
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Answer

Patients with microvascular disease have a high likelihood of resolution. These patients may be observed and advised to patch 1 eye or use monovision lenses to minimize their symptoms.

Similarly, patients who have traumatic fourth nerve palsy may be observed for 6 months prior to surgical intervention because of the possibility of spontaneous resolution; however, some traumatic palsies may recover as late as 1 year after injury. [18]


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