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Eye and Vision Care

Superior Oblique Palsy



what happens if you dont treat superior oblique palsy


Thank you for this interesting question. Unfortunately, the answer is not as simple as the question.

When I see a patient with a superior oblique palsy (fourth cranial nerve palsy), the first question that I need to answer is "what is the cause of the nerve palsy?"  

Some common causes are:

If the underlying cause of the nerve palsy is likely to progress or cause further damage (for example diabetes or a tumor), failure to treat the underlying cause can lead to further complications or even death.

Now for actually treating a superior oblique palsy...

The most common treatments include eye muscle surgery, prism glasses, or wearing a patch to eliminate double vision.

What happens if the nerve palsy is not treated? Well this is also a little complicated as it depends on age.

In a young child, failure to treat a superior oblique palsy may result in development of amblyopia or lazy eye (reduced visual function in the eye with the nerve palsy), reduced depth perception, and/or an abnormal head posture.

In an adult, failure to treat a superior oblique palsy may lead to an abnormal head posture and persistence of the signs and symptoms that are currently being experienced (for example: double vision, uncomfortable vision, reduced depth perception, cosmetic misalignment of eyes).

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Response by:

Andrew J Toole, OD, PhD, FAAO
Clinical Assistant Professor of Optometry
College of Optometry
The Ohio State University