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CASE REPORT
Year : 2022  |  Volume : 2  |  Issue : 3  |  Page : 732-735

Modified Nishida: An innovative approach to tackle third nerve palsy


Department of Ophthalmology, Paediatric and Squint Services, B. W. Lion's Super-Speciality Eye Hospital, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Sonali Rao
SA 601, Shriram Surabhi Apts, Mallasandra Village, Holiday Village Road, Off Kanakpura Road, Bengaluru - 560 062, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_2956_21

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It is commonly acknowledged that surgery for correction of strabismus associated with third nerve palsy can be very challenging for an ophthalmologist. Understanding the difficulties, we present modified Nishida, an innovative approach to tackle third nerve palsy. The exotropia with hypotropia in an 8-year-old child with RE congenital third nerve palsy was corrected by a single-staged surgery – LR recession + MR plication + modified Nishida, followed by correction of severe ptosis with frontalis sling surgery 2 months after squint surgery. This innovative, simple, and effective technique with no anterior segment ischemia, giving adequate alignment and good stereopsis, is worth bearing in mind while tackling third nerve palsy.


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