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Suggest Medical Tests To Check Which Superior Oblique Muscle Is Affected In Eye
Question: COMMON CONSESIS I HAVE SUPERIOR OBLIQUE PARESIS CAUSING DIPLOPIA CENTRAL FIELD DOWNWARD GAZE, RIGHT HEAD LATERAL FLEXION,ALSO RIGHT HEAD ROTATION .
TORSIONAL AND VERTICAL DIPLOPIA ON DOWNWARD GAZE.
WHICH SUPERIOR OBLIQUE MUSCLE IS NOT WORKING PROPERLY?
further downward gaze:
vertical and diagonal seperated images
ie image one on top of another and also angled by about 40 degrees
as gaze down the distance between the images seperate further also
images start splitting from just above mid line eye view
As move head, everything changes.
long distance vision ok little blurry?but possibly gets worse when tired?at times,but have better than 20 20 vision
TORSIONAL AND VERTICAL DIPLOPIA ON DOWNWARD GAZE.
WHICH SUPERIOR OBLIQUE MUSCLE IS NOT WORKING PROPERLY?
further downward gaze:
vertical and diagonal seperated images
ie image one on top of another and also angled by about 40 degrees
as gaze down the distance between the images seperate further also
images start splitting from just above mid line eye view
As move head, everything changes.
long distance vision ok little blurry?but possibly gets worse when tired?at times,but have better than 20 20 vision
Brief Answer:
Possible eyes axis displacement, myasthenia gravis should be considered too
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
There is only one superior oblique muscle at one side, supplied by trochlear nerve and responsible for downward and outward movement of the eyeball.
To test which superior oblique muscle is affected ( right or left ) is necessary to notice the worsening of diplopia related to head tilting ( if the diplopia is worse when tilting the head to the right, the right superior oblique muscle is responsible ).
You mentioned that Ophthalmologist evaluation didn't find any restrictions on eyeball movements, so there is no eyes muscle paresis.
It is possible that your sight related symptoms are caused by maxillary fractures and eyes axis displacement due to repeated trauma.
In my opinion, another possible cause of worsening of vision problems when fatigued ( or at evening ) that needs to be considered is myasthenia gravis.
I suggest you to discuss these issues with your Neurologist.
Hope you found the answer helpful.
Let me know if I can assist you further.
Greetings.
Possible eyes axis displacement, myasthenia gravis should be considered too
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
There is only one superior oblique muscle at one side, supplied by trochlear nerve and responsible for downward and outward movement of the eyeball.
To test which superior oblique muscle is affected ( right or left ) is necessary to notice the worsening of diplopia related to head tilting ( if the diplopia is worse when tilting the head to the right, the right superior oblique muscle is responsible ).
You mentioned that Ophthalmologist evaluation didn't find any restrictions on eyeball movements, so there is no eyes muscle paresis.
It is possible that your sight related symptoms are caused by maxillary fractures and eyes axis displacement due to repeated trauma.
In my opinion, another possible cause of worsening of vision problems when fatigued ( or at evening ) that needs to be considered is myasthenia gravis.
I suggest you to discuss these issues with your Neurologist.
Hope you found the answer helpful.
Let me know if I can assist you further.
Greetings.
Above answer was peer-reviewed by :
Dr. Naveen Kumar
Do not have M gravis
All ready looked into that
With trauma mvas would you expect recovery?
Would you expect progression of symptoms over time i.e delayed onset of signs and symptoms or progression of signs and symptoms
Eg in my case
Had small whiplash injury 31 August 2015
Had little difficulty in downward gaze then then couple months later central vision affected ?
The hospital eye clinic says 4 nerve palsy ?
Thyroid blood tests ok
2006 had la forte 2 left side fracture
Left side plate also no fracture on right
Lateral head tilt towards right shoulder separates images further and turning heads to right also so right superior oblique problem?
All ready looked into that
With trauma mvas would you expect recovery?
Would you expect progression of symptoms over time i.e delayed onset of signs and symptoms or progression of signs and symptoms
Eg in my case
Had small whiplash injury 31 August 2015
Had little difficulty in downward gaze then then couple months later central vision affected ?
The hospital eye clinic says 4 nerve palsy ?
Thyroid blood tests ok
2006 had la forte 2 left side fracture
Left side plate also no fracture on right
Lateral head tilt towards right shoulder separates images further and turning heads to right also so right superior oblique problem?
Brief Answer:
Fourth nerve supplies superior oblique muscle.
Detailed Answer:
Welcome back.
If the ophthalmologist results were in favor to fourth cranial nerve palsy, then it is superior oblique muscle affected.
Le Fort fracture may affect nerves that supply eyes muscles by compression during their pathways.
If no complete compression/disruption then improvement is expected.
You should discuss with your Ophthalmologist about learning the oculomotor exercises and using prism glasses.
Central field defect is not related to fourth nerve involvement.
Hope this helps you understand better your condition.
Greetings.
Fourth nerve supplies superior oblique muscle.
Detailed Answer:
Welcome back.
If the ophthalmologist results were in favor to fourth cranial nerve palsy, then it is superior oblique muscle affected.
Le Fort fracture may affect nerves that supply eyes muscles by compression during their pathways.
If no complete compression/disruption then improvement is expected.
You should discuss with your Ophthalmologist about learning the oculomotor exercises and using prism glasses.
Central field defect is not related to fourth nerve involvement.
Hope this helps you understand better your condition.
Greetings.
Above answer was peer-reviewed by :
Dr. Raju A.T
If that is correct
Central field below midline getting worse in downward gaze is due to what in your opinion
Regards
Central field below midline getting worse in downward gaze is due to what in your opinion
Regards
Brief Answer:
Probably optic nerve damage.
Detailed Answer:
Welcome back.
If the central field defect is localized only in one eye, it is most likely related to optic nerve of the same side damage.
Hope this helps.
Regards.
Probably optic nerve damage.
Detailed Answer:
Welcome back.
If the central field defect is localized only in one eye, it is most likely related to optic nerve of the same side damage.
Hope this helps.
Regards.
Above answer was peer-reviewed by :
Dr. Yogesh D
have diplopia
so that is not possible
so that is not possible
Brief Answer:
Field defects related to optic nerve fibers damage.
Detailed Answer:
Welcome back.
Diplopia is a symptom that indicates dysfunction of nerves and/or muscles that control eyeballs movements ( cranial nerves 3,4 and 6), vision field defects are met in damages of optic nerve fibers (cranial nerve 2) from retina to occipital lobe during their pathway.
hope this helps.
Field defects related to optic nerve fibers damage.
Detailed Answer:
Welcome back.
Diplopia is a symptom that indicates dysfunction of nerves and/or muscles that control eyeballs movements ( cranial nerves 3,4 and 6), vision field defects are met in damages of optic nerve fibers (cranial nerve 2) from retina to occipital lobe during their pathway.
hope this helps.
Above answer was peer-reviewed by :
Dr. Yogesh D
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