4th nerve palsy qs

Discussion in 'Optometry Archives' started by Simon Dean, May 2, 2007.

  1. Simon Dean

    Simon Dean Guest


    You may recall the doc at the eye hospital after MRI's and electrical
    testing and all that, and field of vision tests, said I had a fourth
    nerve palsy. About six months later I had an appointment with a doc in
    relation to an accident I had for an insurance claim.

    In his notes, he mentions that all 12 Cranial Nerves are fine.

    I wrote a letter back to set the record straight, and this doctor says
    along the lines...

    "Fourth nerve palsy refers to a vertical misalignment of the eye of
    which none was present when I examined Mr Dean..."


    First, I thought it referred to a nerve weakness and problems with
    transmitting signals. While congenital FNP might have a common symptom
    of vertical misalignment, recent onset can be much more subtle, and my
    issues seem to be in tracking from left to right with my eyes. Apparently.

    I thought this Doc was a bit cheeky, but, nothing worth complaining
    about when taken in context.

    But it just makes me think, how many quacks are out there making up
    stuff on the spot and trying to say it's real?

    Simon Dean, May 2, 2007
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  2. I don't think your standard GP would be able to spot a subtle fourth
    nerve palsey on a "standard" office visit.

    I don't know the particulars, but I'm pretty sure the differences between
    billable office visits (short vs. extended, for example) that docs can
    bill for are basically a checklist. Doing 12 nerves, instead of 8, for
    example, might tip the scales to the next higher level.
    Scott Seidman, May 2, 2007
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  3. Simon Dean

    Simon Dean Guest

    This doc (for the accident insurance/claim) I saw was a consultant
    orthopaedic surgeon, and accurately diagnosed that all 12 cranial nerves
    were fine from "sight" alone.

    Thanks doc, but I'd rather trust the experience of the eye hospital whos
    excellent care I've been under. It just really amuses me how many of
    these doctors are pretending they're expert in everything. If you dont
    know, don't comment!
    Simon Dean, May 2, 2007
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