Resolución quirúrgica de estrabismo divergente secundario a parálisis traumática del III par craneal

Traumatic third cranial nerve palsy involves several extraocular muscles and parasympathetic fibres, with large-angle exotropia and a low probability of spontaneous recovery. The study therefore aimed to describe the diagnostic approach and surgical management of a large-angle divergent strabismus due to complete traumatic third cranial nerve palsy. A descriptive case study of a man with closed craniofacial trauma was conducted. A right exotropia of about 45°, limited adduction, elevation and depression, ptosis and mid-dilated pupil were found; after lateral rectus recession and a medial rectus procedure, functional alignment in primary position was achieved without complications. It was concluded that individualised surgery, once deficit stability is documented, restores primary alignment.