Complete oculomotor nerve palsy presents with a distinctive and challenging clinical picture. When all oculomotor functions are lost, the eye assumes a fixed deviated position and eyelid ptosis develops — a combination that requires a specific management approach.
When the palsy is complete, the eye is fixed in abduction, infraduction, and intorsion, and the eyelid is ptotic. This protocol specifically addresses the management of complete oculomotor nerve palsy in the presence of eyelid ptosis.
The approach involves a mechanical intervention directed at the position of the globe relative to the orbit, in combination with a procedure targeting the lateral extraocular muscle. The full procedural sequence and clinical decision pathway are available in the complete protocol below.