In 1982, a paper in the Archives of Opthamology entitled Chronic Sixth Nerve Palsies indicated that eye doctors commonly encounter sixth nerve palsies. The condition is generally “benign.” If your doctor diagnoses you with sixth nerve palsy, he will investigate for an underlying cause. Multiple treatment options exist, but eye exercises are not usually beneficial.
Three main cranial nerves, the third, fourth and sixth nerves, are responsible for eye movement. Your sixth cranial nerve, also called the abducens nerve, controls the lateral rectus muscle that turns your eye outward, away from your nose. According to the Merck Manuals Medical Online Library, when this nerve is palsied, or paralyzed, “The affected eye cannot turn fully outward and may turn inward when people look straight ahead.”
Possible Causes and Effects
Multiple events can cause sixth nerve palsy. Head trauma, stroke, aneurism, tumors, infections, blockage or lack of blood supply, childhood virus or multiple sclerosis are some conditions that may be responsible for the disorder. Occasionally the condition is congenital. Sometimes it can occur with no other symptoms, and in those cases, your doctor may not find the underlying cause. Often, you will recover from this condition within a few months if your doctor finds no other issues.
Symptoms and Diagnosis
Sixth nerve palsy often presents as double vision, and your eye may turn inward involuntarily. Depending on the cause of this condition, you may experience other symptoms including headaches, swelling in the eye, numbness about the face, vision loss or impaired eye movement in directions other than outward. Your doctor will likely diagnose the problem by examining inside the eye with an ophthalmoscope. If that is fruitless, a CT scan, an MRI or a spinal tap may be used to test for tumors or other problems.
Generally, the treatment for abducens palsy targets the underlying cause of the problem, if the cause can be determined. Solutions might include an eye patch, prism eyeglasses, or surgery in some instances. The North American Neuro-Ophthalmology Society notes that Botox injections have been tried to treat this condition, but since it is usually correctable “over a relatively short time and the results of the injections are unpredictable these would seldom if ever be indicated.”
Eye Exercises and Sixth Nerve Palsy
When asked about eye exercises for sixth nerve palsy, Dr. David Steinberg, M.D. of Precision Eye and Laser in Fishkill, New York explained that they are not recommended because, “it is not a muscle weakness that can be exercised, but rather a nerve which is not sending the proper signal to the muscle; therefore, the exercise would not help.”
- "Archives of Opthamology": Chronic Sixth Nerve Palsies: Are They Really Harbingers of Intercranial Disease?; Peter J. Savino, et. al.; Sept. 1982
- Merck Manuals Medical Online Library: Palsies of Cranial Nerves that Control Eye Movement
- North American Neuro-Ophthalmology Society: Microvascular Cranial Nerve Palsy
- Dr. David Steinberg, MD; Precision Eye and Laser; Fishkill, NY