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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3144
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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My three year old son can not move his left eye toward the

Resolved Question:

My three year old son can not move his left eye toward the left of his face. he can look straight ahead with it and inward toward his nose but can't move any further toward the left than straight ahead.
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Dan B. replied 1 year ago.

Doctor DanB : Hello and thanks for your question. Did they do an imaging study (CAT scan or MRI) on his head at the ER?
Customer:

I don't believe they did. My husband had taken him and he is now out to sea so i can not ask him but i believe they did not

Customer:

but my husband did say that the ER doc said it was not neurological

Doctor DanB : Well that may be reassuring. Is this new, a sudden onset?
Customer:

yes it is new. one day his eyes were fine and the next he looked cross eyed.

Doctor DanB : Has he had a viral infection recently?
Customer:

no he has not. he has had some high fevers over the past few months but nothing within the last couple of weeks

Doctor DanB : From what you have told me, this sounds like he has an acute-onset strabismus (or eye misalignment); possibly a sixth-nerve palsy. Is the ER arranging for him to see an ophthalmologist today, in the ER?
Customer:

no they are not today. the opthalmologist office is not open till tomorrow. my son went to the er about a week ago but it seems to me that his eye is less mobile since then

Doctor DanB : Was there any trauma to his head or eye?
Customer:

not really, he has had a few falls and bumped his head not nothing major or nothing recently

Doctor DanB :

Okay, while I cannot examine your child as the ER doctor can, I would be hesitant to agree with the ER doctor that this isn't neurologic without an assessment by either an ophthalmologist or a neurologist; if the eye really is not able to move out at all and this is a new, sudden onset, this could be a sixth-nerve palsy. While most sixth nerve palsies in kids are either trauma or viral in nature, it is much less likely, though still possible that an intracranial mass could cause this as well (which would necessitate a CT or MRI scan to rule this out).

Customer:

That is what I am afraid of.

Customer:

could it be anything else causing his eye not to turn to the left?

Doctor DanB :

This is a useful description of a sixth-nerve palsy from the American Academy of Pediatric Ophthalmology: http://www.aapos.org/terms/conditions/98

Customer:

do you think I should take him to the ER today and have them preform these tests or just want till I hear back for the ophthalmologist?

Doctor DanB :

It's possible that he has developed a type of strabismus called esotropia (where one eye turns in); in a large-angle esotropia (where the eye is turned in significantly), it can sometimes appear that the child cannot move the eye out, where in fact he can, but the esotropia makes it harder to see the eye move out. This is where the exam by the ophthalmologist is going to be critical. How soon do you think he will be seen by the ophthalmologist?

Customer:

I have no idea when. it could be this week or weeks time

Doctor DanB :

Knowing that, unless he can be seen by a neurologist within a week's time, if he were my son, I would want my son to have the CT scan of the head and eyes.

Customer:

Thank you, XXXXX XXXXX helpful. I may take to the ER today.

Doctor DanB :

My pleasure. Good luck to you!


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My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.

Doctor DanB :

Please rate your encounter with me by providing feedback; any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. If you feel like your concerns are not resolved or you have a problem or issue with anything I have said or haven’t said, please don’t issue a negative feedback rating—My goal is your satisfaction and I would rather work together to solve your concerns, until you are satisfied, than have you leave our encounter unhappy and unsatisfied.



Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3144
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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