11-year-old Mitansh Verma* was a quiet boy who loved playing video games. In the late afternoon, he would often take a stroll on the quiet roads of Pune as he returned from school. Once while walking home, a fruit seller vendor accidentally collided with him and he lost his balance. He fell down on his head and did develop a bump on his head too. When he reached home, he had 2-3 episodes of vomitting. Next day, he noticed that his right eye had turned Inwards and was experiencing double vision.
This observation brought him and his mother to their family doctor the next day. Their doctor advised Mrs. Verma to consult a paediatric eye doctor from Advanced Eye Hospital & Institute (AEHI), in Sanpada, Navi Mumbai.
Mother-son duo reached AEHI and initiated with the registration formalities. Mitansh was then referred to consult Dr. Prachi Agashe, a Paediatric Ophthalmologist and a Squint Surgeon at AEHI. She observed Mitansh’s eyes and did a thorough eye examination.This evaluation revealed that he had esotropia (convergent squint) due to right sided sixth nerve paresis.
Sixth nerve palsy is a disorder linked with the dysfunction of cranial nerve VI that is responsible for eye muscle contraction to capture the ‘turning out’ of the eye.
But, due to external physical trauma like head injury or skull fracture can damage this nerve that stops sending signal to the lateral rectus (eye) muscle thereby weakening it and hence restricts the eye movement. Depending upon the severity of the damage, it gives poor eye alignment. The most common symptoms are headache, difficulty in doing tasks that requires viewing to nearby objects, double vision, and turning head to one side to avoid double vision etc.
Patients who suffer from recent onset convergent squint experience problem in coordinating their eye movements and may experience double vision Eyes show tendency to deviate inwards.
Dr. Prachi further asked him to do MRI scan of his brain which revealed a subdural haemorrhage. for which a neurologist was also consulted.
Dr. Prachi then prescribed him oral steroids containing medicines and few eye exercises. He was then asked to follow up after a week.
In the follow up session, Mitansh then showed gradual progress. Dr. Agashe further prescribed him prism glasses to relieve him of his double vision and asked to follow up after one month. Gradually over couple of months, Mitansh was relieved to have gotten rid of the symptoms and his eyes also completely became straight
Esotropia is an eye condition that is typically discovered during childhood. Patients who suffer from this disorder experience problem in coordinating their eye movements. Eyes show tendency to deviate inward. Treatment of esotropia depends on the severity of the symptoms.
Sometimes children are likely to get head injuries which is one of the major reasons affecting the 6th cranial nerve. However, cranial nerve disorders can be a part of are some serious neurological disorders. Luckily, this was not the case for Mitansh. The recovery period for sixth nerve palsy owing to head injury after thorough medication and eye exercises can range from a month to six months. However, if the squint persists more than six months it is important to align the eyes through muscle surgery. Hence, like Mitansh’s mother, it is important to initiate prompt action to consult a paediatric ophthalmologist for an immediate eye check-up to diagnose the eye condition from neurological disorders.
About Dr. Prachi Agashe
Dr. Prachi Agashe, (Pediatric Ophthalmology, DNB (Ophth), MBBS) is an Adult Squint Surgeon and Pediatric Ophthalmologist at the Advanced Eye Hospital. She has several years of experience and expertise in dealing with eye problems like Strabismus, Amblyopia (aka lazy eye), Congenital Abnormalities, Childhood Cataract, etc. Consult Dr. Prachi Agashe by booking an appointment.
About Advanced Eye Hospital and Institute:
Advanced Eye Hospital and Institute in Navi Mumbai is one of the best eye hospitals in Mumbai. Comprehensive eye check-up and the operation theatres are state-of-art and equipped with the best diagnostic and surgery machines. Personalized care, infection free modular operation theatres and beautiful ambiance compliment the innovative eye care service offered at AEHI. Besides Kharghar, Nerul, Vashi and Panvel, patients from all over western India travel to AEHI for world class eye care management.
Advanced Eye Hospital And Institute (AEHI) can be reached at (O): +91 22 67313636, (Emergency): +91 9167360360 or even through Email: email@example.com
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