Terapia visual y rehabilitación multidisciplinaria de la parálisis del tercer nervio craneal: reporte de caso mexicano
Introduction: Traumatic brain injury (tbi) frequently affects the third cranial nerve, causing oculomotor alterations such as limited adduction, ptosis, and mydriasis. Motor, sensory, and perceptual deficits in these patients are rarely rehabilitated, as treatment usually focuses on surgery and anti-inflammatory therapies. After an interdisciplinary management approach, this article describes the clinical evolution of sensory, motor, and perceptual skills of a 26-year-old male with a third nerve palsy secondary to a tbi. Case Report: A 26-year-old male presented with left-eye 60D exotropia, diplopia, balance issues, photophobia, superior visual field defects, and headaches caused by a tbi sustained four months earlier. A personalized optometric visual therapy program was designed and implemented to rehabilitate the patient’s oculomotor, sensory, and perceptual visual skills. The interdisciplinary approach included Botox therapy administered by strabismologists. Conclusions: The combination of optometric visual therapy and Botox effectively improved the patient’s symptoms, restoring binocular, sensory, and perceptual visual skills to near-normal levels. These results remained stable months after treatment. Further physiological studies are needed to clarify the mechanism of action of optometric visual therapy, as it could reduce or eliminate the need for repeated Botox applications in patients with third nerve palsy caused by brain trauma. Interdisciplinary approaches are crucial for maximizing therapeutic benefits and enhancing patients’ quality of life.
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